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A Mouse Model of Intestinal Partial Obstruction
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Lupus intestinal pseudo-obstruction and hydronephrosis: Case report
Brittany L Adler1, Homa Timlin, Julius Birnbaum
1Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Medicine
|July 16, 2019
Summary
Lupus can cause rare intestinal pseudo-obstruction (IPO), a serious condition. Prompt immunosuppression treatment effectively resolves IPO symptoms and allows for long-term remission.
Area of Science:
- Gastroenterology
- Rheumatology
- Nephrology
Background:
- Intestinal pseudo-obstruction (IPO) is a rare, life-threatening complication of systemic lupus erythematosus (SLE).
- IPO in SLE is often associated with genitourinary issues like ureterohydronephrosis and interstitial cystitis.
Observation:
- A patient with long-standing lupus presented with recurrent abdominal pain, distension, nausea, and emesis.
- Imaging revealed dilated small bowel loops with air-fluid levels, bowel wall thickening, and bilateral hydronephrosis.
Findings:
- High-dose intravenous steroids and cyclophosphamide led to symptom resolution within one week.
- The patient was transitioned to mycophenolate mofetil and achieved sustained remission, allowing immunosuppression cessation after one year.
Implications:
- This case highlights that IPO in lupus, potentially due to smooth muscle dysmotility, is responsive to immunosuppressive therapy.
- Early recognition and prompt treatment of IPO in SLE patients are crucial for favorable outcomes.
- Understanding the pathophysiology of smooth muscle dysmotility in SLE-related IPO warrants further investigation.
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