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一名小儿起病的系统性红斑狼疮患者并发粪性结肠炎:病例分析及文献复习

Stercoral Colitis in a Patient With Pediatric-Onset Systemic Lupus Erythematosus: Case Analysis and Review of the Literature.

作者信息

Gau Chun-Chun, Lin Li-Lun, Wu Chao-Yi, Huang Jing-Long

机构信息

Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.

出版信息

Front Pediatr. 2021 Oct 27;9:760517. doi: 10.3389/fped.2021.760517. eCollection 2021.

Abstract

Systemic lupus erythematosus (SLE) is an autoantibody-related disease that affects multiple organs. Stercoral colitis (SC) is a rare type of inflammatory colitis with a high mortality rate. Here, we report the first case of pediatric-onset lupus in a case complicated by stercoral colitis. We also conducted a literature review of patients with SC under 30 years old to provide useful clues for rapid diagnosis at a young age. A 28-year-old female with a history of lupus and neuropsychiatric SLE was admitted with severe abdominal pain. She was found to have stercoral colitis during surgery. Two years later, the patient underwent Hartman's operation due to ischemia of the colon. In addition, 10 patients younger than 30 years old with a diagnosis of SC were analyzed based on clinical presentation, physical examination, laboratory exam, imaging and treatment. All cases had a favorable outcome without mortality. Stercoral colitis is a rare but lethal complication, emphasizing the importance of a multidisciplinary approach. Differential diagnosis should include stercoral colitis for patients with SLE developing unexplained sharp abdominal pain.

摘要

系统性红斑狼疮(SLE)是一种与自身抗体相关的疾病,可累及多个器官。粪性结肠炎(SC)是一种罕见的炎症性结肠炎,死亡率很高。在此,我们报告首例合并粪性结肠炎的儿童期发病狼疮病例。我们还对30岁以下的粪性结肠炎患者进行了文献综述,为年轻时的快速诊断提供有用线索。一名有狼疮和神经精神性SLE病史的28岁女性因严重腹痛入院。手术中发现她患有粪性结肠炎。两年后,患者因结肠缺血接受了哈特曼手术。此外,基于临床表现、体格检查、实验室检查、影像学检查和治疗,对10例30岁以下诊断为粪性结肠炎的患者进行了分析。所有病例预后良好,无死亡病例。粪性结肠炎是一种罕见但致命的并发症,强调了多学科方法的重要性。对于出现无法解释的剧烈腹痛的SLE患者,鉴别诊断应包括粪性结肠炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/8578821/fd191eff649e/fped-09-760517-g0001.jpg

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