Ben Dhaou B, Aydi Z, Boussema F, Ben Dahmen F, Baili L, Ketari S, Cherif O, Rokbani L
Service de médecine interne, hôpital Habib Thameur, faculté de médecine, Tunis, Tunisie.
Rev Med Interne. 2013 Jan;34(1):12-6. doi: 10.1016/j.revmed.2012.07.001. Epub 2012 Aug 9.
The occurrence of acute pancreatitis in systemic lupus erythematosus (SLE) is known but rare, and is exceptionally the presenting manifestation. Its pathogenesis is multifactorial, and it is difficult to separate what belongs to vasculitis, thrombotic phenomena in the context of an associated antiphospholipid syndrome, or iatrogenic complications. We report on six cases of lupus pancreatitis.
This is a retrospective monocenter study of 110 patients with SLE. The diagnosis of lupus pancreatitis was established after exclusion of other causes of pancreatitis.
Five women and one man (5.4%) with a mean age of 36.3 years presented with lupus pancreatitis. In four patients the pancreatitis was concurrent with the diagnosis of SLE and it occurred later during an exacerbation of the disease in the two remaining patients. In all patients, pancreatic manifestations were associated with other organ involvement. Clinical manifestations were: abdominal pain (n=6), vomiting (n=3), and fever (n=3). Elevated pancreatic enzyme was noted in all cases. All patients were treated by high doses of glucocorticoids. The outcome was favorable in five patients, and one patient died.
Pancreatitis may be the presenting manifestation of SLE. Its pathogenesis is often multifactorial. The outcome is usually favorable with corticosteroids.
系统性红斑狼疮（SLE）患者中急性胰腺炎的发生虽已为人所知，但较为罕见，且极少作为首发表现。其发病机制是多因素的，很难区分哪些属于血管炎、相关抗磷脂综合征背景下的血栓形成现象，或医源性并发症。我们报告6例狼疮性胰腺炎病例。
这是一项对110例SLE患者进行的回顾性单中心研究。在排除其他胰腺炎病因后确立狼疮性胰腺炎的诊断。
5名女性和1名男性（5.4%）出现狼疮性胰腺炎，平均年龄36.3岁。4例患者的胰腺炎与SLE诊断同时出现，另外2例患者在疾病加重期后期发生胰腺炎。所有患者的胰腺表现均伴有其他器官受累。临床表现为：腹痛（n = 6）、呕吐（n = 3）和发热（n = 3）。所有病例均发现胰腺酶升高。所有患者均接受大剂量糖皮质激素治疗。5例患者预后良好，1例患者死亡。
胰腺炎可能是SLE的首发表现。其发病机制通常是多因素的。使用糖皮质激素治疗后通常预后良好。
