Department of Nephrology and Rheumatology, Sixth People's Hospital, Shanghai Jiao Tong Unversity, 600 Yishan Road, 200233, Shanghai, China.
Rheumatol Int. 2012 Jun;32(6):1701-3. doi: 10.1007/s00296-011-1856-4. Epub 2011 Mar 24.
Intestinal pseudo-obstruction (IPO) is not uncommon in systemic lupus erythematosus (SLE), and IPO in SLE has an apparent association with ureterohydronephrosis. However, hepatobiliary dilatation without mechanical obstruction presenting together with IPO and ureterohydronephrosis is much more scarce in SLE. Here, we named this rare triad of IPO, ureterohydronephrosis, and biliary tract dilatation as visceral muscle dysmotility syndrome (VMDS). It always imitates an acute abdomen and is even life-threatening if treated incorrectly. To diagnose a VMDS, infections and mechanical obstructions should be ruled out carefully. Here, we report a 24-year-old Chinese woman with SLE who presented of VMDS that associated with corticoids tapering induced SLE flare. In this case, early vigorous immunosuppressive treatment conquered the triad timely and thus yielded a good outcome.
肠假性梗阻(IPO)在系统性红斑狼疮(SLE)中并不少见,SLE 中的 IPO 与输尿管肾盂积水明显相关。然而,SLE 中同时出现 IPO 和输尿管肾盂积水而无机械梗阻的肝胆管扩张则更为罕见。在这里,我们将 IPO、输尿管肾盂积水和胆道扩张这一罕见三联征命名为内脏肌肉运动障碍综合征(VMDS)。它常表现为急腹症,如果治疗不当甚至会危及生命。为了诊断 VMDS,应仔细排除感染和机械性梗阻。在此,我们报告了一例 24 岁的中国女性 SLE 患者,表现为 VMDS,与皮质类固醇减量诱导的 SLE 发作有关。在这种情况下,早期积极的免疫抑制治疗及时克服了三联征,从而取得了良好的效果。