Nephrology Department, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Lupus. 2011 Oct;20(12):1324-8. doi: 10.1177/0961203311405702. Epub 2011 Jun 16.
Intestinal pseudo-obstruction (IpsO) occurs in a small subgroup of patients with systemic lupus erythematosus (SLE), and has been under-recognized. The etiology and mechanisms are unclear. Herein, we report two cases. In case 1, IpsO occurred as the complication in a previously diagnosed SLE patient. In case 2, IpsO with an image-evidenced intussusception and a peripheral eosinophilia, was the initial presentation, leading to the diagnosis of SLE. In both cases, IpsO existed concomitantly with ureterohydronephrosis, and evolved into peritonitis, which we called together IpsO syndrome. However, this surgical abdomen-like syndrome had a satisfactory response to glucocorticosteroids instead of antibiotics and surgery. Physician awareness and early diagnosis could positively affect outcomes of this syndrome, avoiding unnecessary surgical intervention.
肠假性梗阻(IpsO)发生在一小部分系统性红斑狼疮(SLE)患者中,且一直未被充分认识。其病因和机制尚不清楚。本文报告两例病例。在病例 1 中,肠假性梗阻是先前诊断为 SLE 患者的并发症。在病例 2 中,肠假性梗阻伴有影像学证据的肠套叠和外周血嗜酸性粒细胞增多,为初始表现,导致 SLE 的诊断。在这两种情况下,肠假性梗阻同时伴有输尿管积水,并发展为腹膜炎,我们称之为肠假性梗阻综合征。然而,这种类似外科急腹症的综合征对糖皮质激素有满意的反应,而不是抗生素和手术。医生的认识和早期诊断可以积极影响这种综合征的结局,避免不必要的手术干预。