Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Rheumatol Int. 2021 Feb;41(2):469-474. doi: 10.1007/s00296-020-04717-y. Epub 2020 Oct 9.
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Although gastrointestinal (GI) involvement is reported in the literature, GI manifestations of lupus are not common in the early disease course. GI symptoms can be related to several factors other than lupus; however, systemic lupus per se can be the responsible factor. Although the typical presentation is a gradual onset of progressive symptoms, acute abdominal pain is frequently reported and is the most serious presentation. It can reflect gastroenteritis, cholecystitis, hepatitis, pancreatitis, peritonitis, and abdominal vasculitis. When SLE diagnostic criteria for GI manifestations are lacking, the decision to implicate lupus as the cause of these manifestations is difficult, especially in the primary presentation. Early diagnosis and the initiation of immunosuppressive agents are associated with a better outcome. In this case, we introduce a patient who presented with acute abdominal pain secondary to acute liver failure as the first manifestation of lupus.
系统性红斑狼疮（SLE）是一种多系统自身免疫性疾病。尽管文献中有胃肠道（GI）受累的报道，但狼疮在疾病早期的胃肠道表现并不常见。GI 症状可能与狼疮以外的多种因素有关；然而，系统性红斑狼疮本身可能是致病因素。尽管典型表现为逐渐出现进行性症状，但常报告出现急性腹痛，这是最严重的表现。它可反映胃肠炎、胆囊炎、肝炎、胰腺炎、腹膜炎和腹部血管炎。当缺乏 GI 表现的 SLE 诊断标准时，很难将狼疮确定为这些表现的病因，尤其是在初次表现时。早期诊断和开始免疫抑制剂治疗与更好的预后相关。在本例中，我们介绍了一位以急性肝功能衰竭继发急性腹痛为狼疮首发表现的患者。
