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Acute abdomen as initial presentation in a patient with Systemic Lupus Erythematosus

Farhad Anoosh, Raza Shariff, Dildeep Ambujakshan, Kalyana Nandipati, James W. Turner, Neil Mandava

Am J Case Rep 2009; 10:55-58

ID: 869651


Background: Systemic lupus erythematosus (SLE) is a multisystern inflammatory disorder that manifests with a variety of symptoms. Systems affected include gastrointestinal, genitourinary, cardiovascular, musculoskeletal, hematologic, and neurologic. Mesenteric vasculitis is a serious but under recognized gastrointestinal complication of SLE and carries a high mortality rate. This article describes a patient with SLE who initially presented with acute abdomen and appendicitis. She was found to have lupus enteritis, or gastrointestinal vasculitis as an initial presentation. The diagnosis and treatment of lupus enteritis are discussed.
Case Report: Case report of a 26-years-old female with acute appendicitis as initial presentation of SLE5. This is a rare case of appendicitis due to SLE.
Conclusions: The case patient presented with signs and symptoms consistent with lupus enteritis. This acute episode was the initial presentation of her disease, corresponded with her active SLE state. Her quick response to corticosteroids, and interval resolution of his CT fi ndings confirmed this. There has been few reports of lupus enteritis in the literature, but all of the case reports are patients with known history of SLE. The presented case is probably the fi rst reported case which the enteritis and acute abdomen is the initial presentation of a systemic lupus erythematous. Lupus enteritis is a recognized entity in patients with SLE and it could be the initial manifestation of SLE. If the physician has a high clinical suspicion of this diagnosis, prompt treatment with corticosteroids is paramount. This approach may prevent the late squeal of lupus enteritis and improve morbidity and mortality in this high-risk patient population.

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