Mizoguchi Fumitaka, Nanki Toshihiro, Miyasaka Nobuyuki
Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Intern Med. 2008;47(13):1267-71. doi: 10.2169/internalmedicine.47.0748. Epub 2008 Jul 1.
We describe a case of systemic lupus erythematosus (SLE) with enteritis and peritonitis who later developed pneumatosis cystoides intestinalis (PCI). A 35-year-old woman with SLE relapsed with enteritis and peritonitis. Prednisolone (PSL) effectively improved her symptoms. However, 6 weeks later, she developed PCI. Tapering of PSL, administration of intravenous cyclophosphamide, prokinetic agents and antibiotics, bowel rest with intravenous hypernutrition therapy and hyperbaric oxygen therapy successfully improved PCI. Although PCI is a rare complication of SLE, the present case suggests that lupus enteritis could be a risk factor for PCI, and that high-dose PSL could cause additional insult to PCI.
我们描述了一例系统性红斑狼疮(SLE)合并肠炎和腹膜炎,随后发展为肠壁囊样积气症(PCI)的病例。一名35岁患有SLE的女性复发并出现肠炎和腹膜炎。泼尼松龙(PSL)有效改善了她的症状。然而,6周后,她发展为PCI。逐渐减少PSL剂量、静脉注射环磷酰胺、给予促动力药和抗生素、通过静脉高营养疗法进行肠道休息以及高压氧治疗成功改善了PCI。尽管PCI是SLE的一种罕见并发症,但本病例表明狼疮性肠炎可能是PCI的一个危险因素,且高剂量PSL可能会对PCI造成额外损害。