Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India.
Currently SMS Medical College and Hospital, Jaipur, India.
Rheumatol Int. 2022 Aug;42(8):1363-1371. doi: 10.1007/s00296-021-04834-2. Epub 2021 Mar 16.
Acute pancreatitis (AP) is a rare but life threatening manifestation of Systemic Lupus Erythematosus (SLE). The current study aims to study the clinical characteristics, severity, mortality, and outcome of SLE-related AP in Indian population. We retrospectively reviewed medical records of patients with SLE who had AP in the past. Data from 13 rheumatology centers across India were compiled. All patients satisfied SLICC criteria for SLE and ATLANTA criteria for AP. AP was classified in to mild, moderate and severe using revised Atlanta classification. Patients with known risk factors like gall stone and alcohol were excluded.Sixty-six patients (six, children) were studied. Majority of patients were females (82%). The median age of presentation was 24 (11-63) years and most patients (57.5%) presented within first year of diagnosis of lupus. AP occurred mostly in the setting of active lupus (89%). Active nephritis was seen in 39% while a fourth had CNS disease. Patients with severe AP had lower C3. Ascites and sepsis were most common local and systemic complications, respectively. Mortality was 17%. Hypocalcemia, presence of sepsis and shock predicted mortality. In the multivariate analysis, only presence of shock remained as independent predictor of death (OR 63.0, 95% CI: 5.2-760.3). Pancreatitis is an early manifestation of SLE and is associated with active disease. Significant mortality is seen particularly with severe pancreatitis.
急性胰腺炎（AP）是红斑狼疮（SLE）一种罕见但危及生命的表现。本研究旨在研究印度人群中与 SLE 相关的 AP 的临床特征、严重程度、死亡率和转归。我们回顾性地分析了过去患有 AP 的 SLE 患者的病历。来自印度各地 13 个风湿病中心的数据被汇编在一起。所有患者均符合 SLE 的 SLICC 标准和 AP 的 ATLANTA 标准。根据修订后的亚特兰大分类，将 AP 分为轻度、中度和重度。排除了已知有胆石症和酒精等风险因素的患者。共研究了 66 名患者（6 名儿童）。大多数患者为女性（82%）。发病时的中位年龄为 24 岁（11-63 岁），大多数患者（57.5%）在狼疮确诊后的一年内发病。AP 主要发生在狼疮活动期（89%）。39%的患者出现活动性肾炎，四分之一的患者有中枢神经系统疾病。重症胰腺炎患者的 C3 水平较低。腹水和感染是最常见的局部和全身并发症。死亡率为 17%。低钙血症、感染和休克的存在预测了死亡率。在多变量分析中，只有休克的存在仍然是死亡的独立预测因素（OR 63.0，95%CI：5.2-760.3）。胰腺炎是 SLE 的早期表现，与活动期疾病有关。尤其是重症胰腺炎患者死亡率较高。
