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Necrotizing mesenteric vasculitis in systemic lupus erythematosus.

Maria Helena Lourenço1, Ana Bento Silva1, Jessica Sousa2

  • 1Rheumatology, Hospital de Egas Moniz, Lisbon, Portugal.

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|April 1, 2024
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Summary

Systemic lupus erythematosus (SLE) can cause severe abdominal pain due to mesenteric vasculitis. This case highlights successful treatment with corticosteroids and cyclophosphamide for this rare complication.

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Area of Science:

  • Gastroenterology
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting multiple organs.
  • Gastrointestinal (GI) symptoms are common in SLE patients, ranging from mild discomfort to severe complications.
  • Mesenteric vasculitis, a rare but serious SLE complication, presents as acute abdominal pain.

Observation:

  • A 57-year-old female SLE patient presented with acute abdominal pain.
  • The patient had recently experienced urinary septic shock.
  • Diagnostic evaluation revealed necrotizing mesenteric vasculitis.

Findings:

  • Necrotizing mesenteric vasculitis was confirmed as the cause of acute abdominal pain in this SLE patient.
  • The patient's condition was successfully managed with high-dose corticosteroid therapy.
  • Immunosuppressive treatment with cyclophosphamide contributed to the resolution of the clinical presentation.

Implications:

  • This case underscores the importance of considering mesenteric vasculitis in SLE patients with acute abdominal pain.
  • Aggressive immunosuppressive therapy, including corticosteroids and cyclophosphamide, can be effective in managing this severe SLE complication.
  • Early diagnosis and prompt treatment are crucial for favorable outcomes in SLE-associated mesenteric vasculitis.