Asadi Gharabaghi Mehrnaz, Abdollahi Pejman, Kalany Mohammad, Sotoudeh Masoud
Department of General Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
J Med Case Rep. 2011 Jun 25;5:235. doi: 10.1186/1752-1947-5-235.
Systemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis.
A 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis.
Considering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.
系统性红斑狼疮（SLE）是一种多系统疾病，可能出现多种症状。它可能以多种方式累及胃肠道；其中一些最常见的是转氨酶升高、狼疮性肠系膜血管炎、狼疮性肠炎和肠系膜血管渗漏。我们描述了一例系统性红斑狼疮患者，该患者有五个月的嗜酸性粒细胞性肠炎引起的腹泻病史。据我们所知，文献中报道的系统性红斑狼疮患者最初因嗜酸性粒细胞性肠炎出现慢性腹泻的病例很少。
一名38岁的波斯伊朗女性因腹泻和腹痛五个月入院。体格检查未发现异常。最初，她仅有淋巴细胞减少和轻度嗜酸性粒细胞增多。未检测到自身免疫或感染病因来解释这些异常。在她出现类似盘状红斑狼疮的头皮病变之前，全面评估对寻找病因并无帮助。计算机断层扫描显示小肠壁增厚。简而言之，她表现为典型的系统性红斑狼疮，且腹泻是由嗜酸性粒细胞性肠炎引起的。
对于出现慢性腹泻和淋巴细胞减少的患者考虑系统性红斑狼疮可能有助于早期诊断和治疗。这是一份对从事内科、家庭医学和胃肠病学的医生有参考价值的原始病例报告。
