Arteritis and venulitis in systemic lupus erythematosus resulting in massive lower intestinal haemorrhage

A case of systemic lupus erythematosus with massive haemorrhage from the colon is described. Histological examination showed ulceration of the mucosa of the ascending colon with necrotizing vasculitis of the submucosal veins. Adjacent arteries were normal apart from one which had ruptured on the surface of an ulcer. This is the first clearly documented case of colonic venulitis in systemic lupus erythematosus and the differential diagnosis of gastrointestinal haemorrhage in this disease is discussed.