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CT findings at lupus mesenteric vasculitis

S F Ko1, T Y Lee, T T Cheng

  • 1Department of Radiology, Chang Gung Medical College and Memorial Hospital, Kaohsiung Hsien, Taiwan.

Acta Radiologica (Stockholm, Sweden : 1987)
|January 1, 1997
PubMed
Summary

Early CT scans can identify lupus mesenteric vasculitis (LMV) using a characteristic "comb sign." Prompt diagnosis and steroid treatment lead to reversible CT findings and improved outcomes for this condition.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Rheumatology

Background:

  • Lupus mesenteric vasculitis (LMV) is an uncommon but serious complication of systemic lupus erythematosus.
  • Early diagnosis and management are crucial for improving patient outcomes.

Purpose of the Study:

  • To characterize the early computed tomography (CT) findings in patients with lupus mesenteric vasculitis.
  • To evaluate the effectiveness of CT in guiding the management of LMV.

Main Methods:

  • Abdominal CT scans were performed on 15 women with systemic lupus erythematosus presenting with severe abdominal pain.
  • High-dose intravenous corticosteroid therapy was initiated promptly after CT diagnosis in 11 patients.
  • Follow-up CT scans were obtained after symptom resolution.

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Main Results:

  • CT revealed characteristic findings of LMV, including mesenteric vessel prominence (CT comb sign), ascites, and bowel wall thickening.
  • The 'CT comb sign' was observed in all 11 diagnosed cases.
  • Follow-up CT demonstrated significant resolution of abnormal findings after steroid therapy.

Conclusions:

  • CT is a valuable tool for diagnosing lupus mesenteric vasculitis, with the 'CT comb sign' being a key early indicator.
  • Early diagnosis and prompt intravenous corticosteroid treatment can lead to reversible CT findings and favorable outcomes in LMV.
  • Bowel ischemia associated with LMV may be less severe than previously thought when treated early.