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Primary lupus-associated protein-losing enteropathy

R L Sunheimer1, C Finck, S Mortazavi

  • 1Department of Pathology, SUNY Health Science Center, Syracuse 13210.

Annals of Clinical and Laboratory Science
|May 1, 1994
PubMed
Summary

This case report highlights a rare presentation of systemic lupus erythematosus (SLE) in an elderly woman, where protein-losing enteropathy was the sole initial symptom. The unusual late onset and unique presentation underscore the diverse manifestations of SLE.

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Area of Science:

  • Internal Medicine
  • Rheumatology
  • Gastroenterology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Protein-losing enteropathy (PLE) is a rare gastrointestinal disorder characterized by excessive protein loss into the intestinal tract.
  • Late-onset SLE (defined as onset at age 50 or later) presents unique diagnostic challenges.

Observation:

  • A 79-year-old Native American female with diabetes mellitus presented with anasarca and hypoalbuminemia.
  • Diagnostic workup, including fecal alpha 1-antitrypsin and indium-labeled transferrin scan, confirmed protein-losing enteropathy.
  • Serological tests revealed a high-titer antinuclear antibody (ANA) with a homogeneous pattern and low-normal serum complement levels.

Findings:

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  • The patient's presentation of PLE as the sole initial symptom was unusual for SLE.
  • The diagnosis of SLE was established based on the combination of PLE and positive serological markers.
  • The late onset of SLE in this patient is also considered atypical.

Implications:

  • This case emphasizes the importance of considering SLE in the differential diagnosis of protein-losing enteropathy, even in elderly patients with atypical presentations.
  • Early recognition and diagnosis of SLE, regardless of age of onset or initial symptoms, are crucial for timely management and improved patient outcomes.
  • Further research into the specific mechanisms linking SLE and protein-losing enteropathy may provide insights into disease pathogenesis and novel therapeutic targets.