Campos Carolina Fernandes Silva, Scrignoli Juliana Alves, de Almeida Lorena Penha, Ferreira Brena Luize, Ribeiro Sandra Lúcia Euzébio, de Lima Domingos Sávio Nunes, Passos Luiz Fernando de Souza
Médica residente do Serviço de Clínica Médica do HUGV-UFAM.
Acta Reumatol Port. 2010 Apr-Jun;35(2):236-40.
Systemic Lupus Erythematosus (SLE) is an autoimmune disease, with multisystemic involvement. Gastrointestinal symptoms are common, like nausea, vomiting and dyspepsia. Acute pancreatitis is an unusual manifestation of SLE, being an important differential diagnosis in evaluation of abdominal pain. The patients usually presents with pain of variable intensity, some occasions simulating acute abdomen. Several factors have been implicated in the pathogenesis of this condition, such as vasculitis, drugs and antiphospholipid antibodies. The role of corticosteroids as etiologic factor remains controversial. Due to the rarity of SLE associated to pancreatitis, we report two cases of patients with severe inflammatory process. In one case, it was used corticosteroids in high doses during treatment, with good outcome. In another, the patient died because of pancreatic pseudocyst rupture and its postoperative hemodynamic complications. In the reported cases, predisposing factors for acute pancreatitis were not verified, so it was considered a primary manifestation of SLE activity.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，可累及多个系统。胃肠道症状较为常见，如恶心、呕吐和消化不良。急性胰腺炎是SLE的一种罕见表现，在评估腹痛时是重要的鉴别诊断。患者通常表现为程度不一的疼痛，有时类似急腹症。多种因素与该病症的发病机制有关，如血管炎、药物和抗磷脂抗体。皮质类固醇作为病因因素的作用仍存在争议。由于SLE合并胰腺炎较为罕见，我们报告两例严重炎症过程的患者。其中一例在治疗期间使用了高剂量皮质类固醇，效果良好。另一例患者因胰腺假性囊肿破裂及其术后血流动力学并发症死亡。在所报告的病例中，未证实急性胰腺炎的诱发因素，因此认为是SLE活动的主要表现。
