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KMID : 0614620160670020107
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Korean Journal of Gastroenterology
2016 Volume.67 No. 2 p.107 ~ p.111
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Panenteritis as an Initial Presentation of Systemic Lupus Erythematosus
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이한아:Lee Han-Ah
심혜기:Shim Hye-Gi/서영호:Seo Young-Ho/최성재:Choi Sung-Jae/이범재:Lee Beom-Jae/이영호:Lee Young-Ho/지종대:Ji Jong-Dae/김재훈:Kim Jae-Hoon/송관규:Song Gwan-Gyu
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Abstract
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Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE), needing prompt diagnosis and proper management. However, SLE rarely presents as lupus enteritis at the time of initial diagnosis. Thus, delayed diagnosis and misdiagnosis are common. We report a case of a 25-year-old woman with lupus panenteritis. The patient had multiple hospitalizations for abdominal pain, nausea, and diarrhea, initially without any other symptoms suggestive of SLE, but was later observed to have malar rash and oral ulcers. Laboratory investigations were compatible with SLE, including positive antinuclear antibody (1:320) with speckled pattern. CT revealed diffuse hypodense submucosal thickening of the stomach, the entire small bowel, colon, appendix, and rectum. Treatment with high-dose corticosteroids followed by maintenance therapy with mycophenolate mofetil, hydroxychloroquine, and azathioprine resulted in clinical improvement. Diagnosis of lupus enteritis requires a high index of suspicion given the low incidence and nonspecific clinical findings.
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KEYWORD
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Systemic lupus erythematosus, Enteritis
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