Department of Rheumatology, ISIC Superspeciality Hospital, Vasant Kunj, New Delhi, India.
Int J Rheum Dis. 2011 Feb;14(1):98-104. doi: 10.1111/j.1756-185X.2010.01581.x. Epub 2010 Nov 9.
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune connective tissue disease with protean manifestations. Most often it presents with mucocutaneous, musculoskeletal or renal involvement. In comparison, gastrointestinal (GI) manifestations of SLE are far less common. The case presented here highlights the differential diagnosis of GI manifestations of SLE that range from non-life-threatening to serious life-threatening complications, including some of the complications of on-going drug treatments. While some of them present as 'acute abdomen', others are more subacute or chronic, yet serious enough to be life-threatening. The serious GI manifestations of SLE include mesenteric vasculitis causing perforation or hemorrhage with peritonitis, acute pancreatitis and intestinal pseudo-obstruction. The patient in this paper had clinical features, imaging findings and laboratory parameters that helped the treating physician to narrow down the diagnostic possibilities and finally, in making the diagnosis of lupus-pancreatitis. She was treated with intravenous 'bolus' (i.v.-pulse) methylprednisolone for 3 days, i.v.-pulse cyclophosphamide 750 mg (one dose) along with oral methylprednisolone and other supportive measures including blood transfusions. This led to prompt and complete recovery.
系统性红斑狼疮（SLE）是一种慢性多系统自身免疫性结缔组织疾病，表现多样。最常见的是黏膜皮肤、肌肉骨骼或肾脏受累。相比之下，SLE 的胃肠道（GI）表现则少见得多。本文介绍的病例强调了 GI 表现的鉴别诊断，范围从无生命危险到严重的危及生命的并发症，包括一些正在进行的药物治疗的并发症。有些表现为“急腹症”，有些则更亚急性或慢性，但严重到足以危及生命。SLE 的严重胃肠道表现包括肠系膜血管炎导致穿孔或出血伴腹膜炎、急性胰腺炎和假性肠梗阻。本文中的患者具有临床特征、影像学发现和实验室参数，这些特征帮助治疗医生缩小了诊断可能性，并最终做出狼疮性胰腺炎的诊断。她接受了 3 天静脉“推注”（i.v.-pulse）甲基强的松龙、静脉推注环磷酰胺 750mg（一剂）以及口服甲基强的松龙和其他支持性措施，包括输血。这导致了迅速和完全的恢复。
