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Acute lupus peritonitis successfully treated with steroid pulse therapy
A Andoh1, Y Fujiyama, S Kitamura
1Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
Journal of Gastroenterology
|November 14, 1997
Summary
Acute lupus peritonitis, a severe complication of systemic lupus erythematosus (SLE), presents with significant abdominal symptoms. Steroid pulse therapy effectively treated this rare condition in a young male patient.
Area of Science:
- Rheumatology
- Gastroenterology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Gastrointestinal involvement in SLE can be severe and challenging to diagnose.
- Acute lupus peritonitis is a rare but serious complication requiring prompt recognition.
Observation:
- A 21-year-old male with SLE presented with acute lupus peritonitis during a generalized flare.
- Symptoms included nausea, vomiting, diarrhea, abdominal tenderness, and decreased bowel sounds.
- Imaging revealed thickened gastrointestinal walls, intraluminal fluid, and ascites.
Findings:
- Endoscopy showed edematous gastric and duodenal mucosa with erosions.
- Ascitic fluid analysis demonstrated low complement levels and elevated anti-DNA antibodies.
- The patient's condition resolved following high-dose steroid pulse therapy (methylprednisolone).
Implications:
- Acute lupus peritonitis should be considered in SLE patients with severe abdominal symptoms.
- Steroid pulse therapy appears to be an effective treatment for acute lupus peritonitis.
- This case highlights the importance of recognizing and managing rare gastrointestinal manifestations of SLE.