Ideguchi H, Misumi M, Inoue Y, Ohkubo T, Tsuji T, Ohno S, Ueda A, Aoki A, Hagiwara E, Shirai A, Mizushima S, Ohno M, Nagaoka S, Ishigatsubo Y
First Department of Internal Medicine, Yokohama City University School of Medicine, Fukuura, Kanazawa-ku, Yokohama-city.
Ryumachi. 2000 Dec;40(6):910-6.
We report two cases of systemic lupus erythematosus (SLE) diagnosed when acute peritonitis was appeared. Case 1 was a 20 year-old woman suffering from stomachache and right lower abdominal pain. Case 2 was a 40 year-old woman with diarrhea, epigastralgia, pollakisuria. In both cases, their peritoneal fluids were exudative with positive autoantibodies. After high dose steroid therapy, abdominal symptoms and ascites improved promptly. However, due to the complication of lupus nephritis, additional therapy was necessary. To characterize the feature of lupus peritonitis (LP), we examined the clinical and laboratory findings of LP from the literature. In patients with acute LP, abdominal pain, vomiting, diarrhea were significantly more common compared with chronic LP patients (P < 0.05), and fever, arthritis, central nervous system involvement and cystitis were more common. In patients with chronic LP, pleural effusion and pericardial effusion were more common compared with acute LP patients. Gastrointestinal manifestations such as abdominal pain, vomiting and diarrhea were more common in patients with acute LP compared with patients with chronic LP. Most patients with chronic LP were asymptomatic, ascites and serositis being the only clinical findings. The response to steroid therapy was better in acute LP.
我们报告了两例在出现急性腹膜炎时被诊断为系统性红斑狼疮（SLE）的病例。病例1是一名20岁女性，患有胃痛和右下腹疼痛。病例2是一名40岁女性，有腹泻、上腹部疼痛、尿频。在这两个病例中，她们的腹腔积液均为渗出液，自身抗体呈阳性。经过大剂量类固醇治疗后，腹部症状和腹水迅速改善。然而，由于狼疮性肾炎的并发症，还需要额外的治疗。为了描述狼疮性腹膜炎（LP）的特征，我们从文献中研究了LP的临床和实验室检查结果。在急性LP患者中，与慢性LP患者相比，腹痛、呕吐、腹泻明显更常见（P < 0.05），发热、关节炎、中枢神经系统受累和膀胱炎更常见。在慢性LP患者中，与急性LP患者相比，胸腔积液和心包积液更常见。与慢性LP患者相比，急性LP患者中腹痛、呕吐和腹泻等胃肠道表现更常见。大多数慢性LP患者无症状，腹水和浆膜炎是唯一的临床表现。急性LP对类固醇治疗的反应更好。
