15 March 2026
: Case report 
Delayed Recognition of Systemic Lupus Erythematosus Presenting With Visceral Muscle Dysmotility and Chronic Mucus-Bloody Enteropathy: A Case Report
Unusual clinical course, Challenging differential diagnosis
Settanan Plangsiri
ABCDEF 1, Manisara Jirapornsuwan BEF 1, Pat Ngamdachakij ACDEF 1, Dhanesh Pitidhammabhorn CD 2, Wannisa Wongpipathpong ADEFG 2*
DOI: 10.12659/AJCR.950774
Am J Case Rep 2026; 27:e950774
Table 2 Laboratory findings at our hospital.
| Category | Test | Result | Reference range | Unit |
|---|---|---|---|---|
| Complete blood count | Hemoglobin | 7.7 | 12–16 | g/dL |
| Mean corpuscular volume | 76.9 | 80–99 | fL | |
| Hematocrit | 24.3 | 36–48 | % | |
| Reticulocyte count | 2.5 | 0.9–2.1 | % | |
| WBC count | 2,580 | 4,000–10,000 | cells/mm | |
| Neutrophils | 74 | N/A | % | |
| Lymphocytes | 22 | N/A | % | |
| Monocytes | 2 | N/A | % | |
| Platelet count | 133,000 | 140,000–450,000 | cells/mm | |
| Electrolytes | Sodium | 141 | 136–145 | mmol/L |
| Potassium | 2.49 | 3.50–5.10 | mmol/L | |
| Chloride | 112 | 98–107 | mmol/L | |
| Bicarbonate | 15.2 | 22–29 | mmol/L | |
| Renal function | Creatinine | 1.21 | 0.8–1.3 | mg/dL |
| Blood urea nitrogen | 21 | 6–24 | mg/dL | |
| Inflammatory marker | C-reactive protein | 30.6 | 3–10 | mg/L |
| ESR | 55 | 0–20 | mg/dL | |
| Complement C3 | 0.26 | 0.75–1.75 | g/L | |
| Complement C4 | 0.04 | 0.16–0.48 | g/L | |
| Liver function | AST | 133 | 0–35 | units/L |
| ALT | 22 | 0–45 | units/L | |
| ALP | 67 | 30–120 | units/L | |
| GGT | 96 | 0–30 | units/L | |
| Total serum protein | 59 | 60–83 | g/L | |
| Albumin | 20.2 | 34–54 | g/L | |
| Total bilirubin | 0.3 | 0.1–1.2 | mg/dL | |
| Direct bilirubin | 0.1 | >0.0 | mg/dL | |
| Urinalysis | RBC count | 3–5 | 0–5 | /HPF |
| WBC count | 1–2 | 0–5 | /HPF | |
| Urine protein | 2+ | 0 | – | |
| Spot UPCR | 4.29 | <0.2 | – | |
| Autoimmune panel | ANA titer | 1: 1280 | N/A | – |
| ANA pattern | Homogenous | N/A | – | |
| Anti-dsDNA | 1+ | 0 | – | |
| Anti-histone | 2+ | 0 | – | |
| Anti-nucleosome | 3+ | 0 | – | |
| AMA-M2 | Borderline | None | – | |
| Anticardiolipin IgM | Negative | <12 | PL-IgM-U/mL | |
| Anticardiolipin IgG | Negative | <12 | GPL | |
| Lupus anticoagulant | Negative | None | – | |
| Beta2 glycoprotein IgM | Negative | <20 | MPL | |
| Beta2 glycoprotein IgG | Negative | 0–20 | U/mL | |
| ALP – alkaline phosphatase; ALT – alanine transaminase; AMA-M2 – anti-mitochondrial antibody M2 subtype; ANA – antinuclear antibody; AST – aspartate aminotransferase; dsDNA – double-stranded DNA; ESR – erythrocyte sedimentation rate; GGT – gamma-glutamyltransferase; GPL – IgG phospholipid units; HPF – high-power field; IgG – immunoglobulin G; IgM – immunoglobulin M; MPL – IgM phospholipid units; N/A – not applicable; RBC – red blood cell; UPCR – urine protein-to-creatinine ratio; WBC – white blood cell. | ||||