Systemic lupus erythematosus with intestinal perforation: A case report

Gu,Yuqing; Zhu,Tao; Wang,Yiqing; Xu,Hongxing

doi:10.3892/etm.2015.2639

Systemic lupus erythematosus with intestinal perforation: A case report

Authors:
- Yuqing Gu
- Tao Zhu
- Yiqing Wang
- Hongxing Xu
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Affiliations: Department of General Surgery, Taicang Hospital Affiliated to Soochow University, Taicang, Jiangsu 215400, P.R. China, Department of Intensive Care Unit, Taicang Hospital Affiliated to Soochow University, Taicang, Jiangsu 215400, P.R. China
Published online on: July 15, 2015 https://doi.org/10.3892/etm.2015.2639
Pages: 1234-1238

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Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease, which can affect almost all systems and organs. Gastrointestinal disorder is one of the most noteworthy complications of patients with SLE. However, gastrointestinal disorder with intestinal perforation is rare, but potentially life‑threatening if not treated promptly. The present study reported a case of SLE with intestinal perforation, where surgical intervention was performed and a crevasse (~3 cm in diameter) was detected in the ileum, ~60 cm from the ileocecal valve. Following surgery, the patient suffered from difficult ventilator weaning, septic shock and intestinal obstruction. The patient was successfully treated and discharged from the hospital after ~4 months of treatment. Intestinal perforation in SLE patients is potentially life‑threatening; early diagnosis and prompt treatment are crucial to the management of this rare complication of SLE.

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1	Meszaros ZS, Perl A and Faraone SV: Psychiatric symptoms in systemic lupus erythematosus: A systematic review. J Clin Psychiatry. 73:993–1001. 2012. View Article : Google Scholar : PubMed/NCBI
2	Janessens P, Arnaud L, Galicier L, Mathian A, Hie M, Sene D, Haroche J, Veyssier-Belot C, Huynh-Charlier I and Grenier PA: Lupus enteritis: From clinical findings to therapeutic management. Orphanet J Rare Dis. 8:672013. View Article : Google Scholar : PubMed/NCBI
3	Malaviya AN, Sharma A, Agarwal D, Kapoor S, Garg S, Singh S and Rawat R: Acute abdomen in SLE. Int J Rheum Dis. 14:98–104. 2011. View Article : Google Scholar : PubMed/NCBI
4	Chng HH, Tan BE, Teh CL and Lian TY: Major gastrointestinal manifestations in lupus patients in Asia: Lupus enteritis, intestinal pseudo-obstruction and protein-losing gastroenteropathy. Lupus. 19:1404–1413. 2010. View Article : Google Scholar : PubMed/NCBI
5	Xu D, Yang H, Lai CC, Li P, Zhang X, Yang XO, Zhang FC and Qian JM: Clinical analysis of systemic lupus erythematosus with gastrointestinal manifestations. Lupus. 19:866–869. 2010. View Article : Google Scholar : PubMed/NCBI
6	Medina F, Ayala A, Jara LJ, Becerra M, Miranda JM and Fraga A: Acute abdomen in systemic lupus erythematosus: The importance of early laparotomy. Am J Med. 103:100–105. 1997. View Article : Google Scholar : PubMed/NCBI
7	Al-Hakeem MS and McMillen MA: Evaluation of abdominal pain in systemic lupus erythematosus. Am J Surg. 176:291–294. 1998. View Article : Google Scholar : PubMed/NCBI
8	Tian XP and Zhang X: Gastrointestinal involvement in systemic lupus erythematosus: Insight into pathogenesis, diagnosis and treatment. World J Gastroenterol. 16:2971–2977. 2010. View Article : Google Scholar : PubMed/NCBI
9	Mok MY, Wong RW and Lau CS: Intestinal pseudo-obstruction in systemic lupus erythematosus: An uncommon but important clinical manifestation. Lupus. 9:11–18. 2000. View Article : Google Scholar : PubMed/NCBI
10	Garcia López CA, Laredo-Sánchez F, Malagón-Rangel J, Flores-Padilla MG and Nellen-Hummel H: Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: A real diagnostic challenge. World J Gastroenterol. 20:11443–11450. 2014. View Article : Google Scholar : PubMed/NCBI
11	Khairullah S, Jasmin R, Yahya F, Cheah TE, Ng CT and Sockalingam S: Chronic intestinal pseudo-obstruction: A rare first manifestation of systemic lupus erythematosus. Lupus. 22:957–960. 2013. View Article : Google Scholar : PubMed/NCBI
12	Ahn E, Luk A, Chetty R and Butany J: Vasculitides of the gastrointestinal tract. Semin Diagn Pathol. 26:77–88. 2009. View Article : Google Scholar : PubMed/NCBI
13	Huang DF and Chen WS: Images in clinical medicine. Lupus-associated intestinal vasculitis. N Engl J Med. 361:e32009. View Article : Google Scholar : PubMed/NCBI
14	Lee CK, Ahn MS, Lee EY, Shin JH, Cho YS, Ha HK, Yoo B and Moon HB: Acute abdominal pain in systemic lupus erythematosus: Focus on lupus enteritis (gastrointestinal vasculitis). Ann Rheum Dis. 61:547–550. 2002. View Article : Google Scholar : PubMed/NCBI
15	Lian TY, Edwards CJ, Chan SP and Chng HH: Reversible acute gastrointestinal syndrome associated with active systemic lupus erythematosus in patients admitted to hospital. Lupus. 12:612–616. 2003. View Article : Google Scholar : PubMed/NCBI
16	Passam FH, Diamantis ID, Perisinaki G, Saridaki Z, Kritikos H, Georgopoulos D and Boumpas DT: Intestinal ischemia as the first manifestation of vasculitis. Semin Arthritis Rheum. 34:431–441. 2004. View Article : Google Scholar : PubMed/NCBI
17	Ju JH, Min JK, Jung CK, et al: Lupus mesenteric vasculitis can cause acute abdominal pain in patients with SLE. Nat Rev Rheumatol. 5:273–281. 2009. View Article : Google Scholar : PubMed/NCBI
18	Hsu CL, Chen KY, Yeh PS, et al: Outcome and prognostic factors in critically ill patients with systemic lupus erythematosus: A retrospective study. Crit Care. 9:R177–R183. 2005. View Article : Google Scholar : PubMed/NCBI
19	Tan TC, Wansaicheon GK and Thong BY: Acute onset of systemic lupus erythematosus with extensive gastrointestinal and genitourinary involvement. Lupus. 21:1240–1243. 2012. View Article : Google Scholar : PubMed/NCBI
20	Majithia R, Joy G, Liang J and Olden K: Acute abdominal pain in systemic lupis erythematosus. Gastrointest Endosc. 75:1267–1268. 2012. View Article : Google Scholar : PubMed/NCBI
21	Lee J, Jung HS, Nam HC, Kwok SK, Ju JH, Park KS, Kim HY and Park SH: Fulminant amoebic colitis mimicking intestinal vasculitis in a patient with systemic lupus erythematosus. Lupus. 21:1351–1355. 2012. View Article : Google Scholar : PubMed/NCBI
22	Kishimoto M, Nasir A, Mor A and Belmont HM: Acute gastrointestinal distress syndrome in patients with systemic lupus erythematosus. Lupus. 16:137–141. 2007. View Article : Google Scholar : PubMed/NCBI