Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Area of Science:

• Radiology
• Gastroenterology
• Rheumatology

Background:

• Gastrointestinal (GI) complications in Systemic Lupus Erythematosus (SLE) involve multiple segments and compartments.
• Accurate assessment of SLE GI involvement is crucial for effective patient management.
• Current evaluation methods may not fully capture the extent and severity of GI disease in SLE.

Purpose of the Study:

• To develop and validate a computed tomography (CT) image-based scoring system for evaluating GI complications in SLE.
• To correlate CT findings with the time to GI functional recovery in SLE patients.

Main Methods:

• Retrospective analysis of abdominal CT scans with contrast in SLE patients with GI involvement from two independent cohorts.
• Development of a CT scoring system incorporating GI tract involvement, intestinal wall thickness, and extra-GI compartment involvement.
• Validation of the CT scoring system against the time to GI functional recovery (tolerable per os intake ≥50% of ideal calories).

Main Results:

• The CT scores for SLE GI involvement were positively correlated with the time to GI functional recovery in both derivation (r=0.57) and validation (r=0.42) cohorts.
• Patients with a CT score ≤ 3 achieved faster GI functional recovery (median 0 days).
• Patients with a CT score > 3 experienced significantly prolonged recovery (median 13 days).

Conclusions:

• A CT-based scoring system effectively assesses the severity of GI involvement in SLE.
• This scoring system demonstrates a significant correlation with the time to GI functional recovery.
• The developed CT scoring system can aid in more accurate assessment and individualized management of SLE patients with GI complications.