Baharloo Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Department of Gastroenterology, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
J Med Case Rep. 2021 Dec 26;15(1):611. doi: 10.1186/s13256-021-03216-3.
Systemic lupus erythematosus is an inflammatory disease affecting several organs. Serositis is one of the systemic lupus erythematosus presentations, but peritonitis is a relatively rare presentation. Particularly, it is extremely rare to observe peritonitis as the first presentation of systemic lupus erythematosus.
Here, we present a case of peritonitis without other symptoms of systemic lupus erythematosus, in a patient who was finally diagnosed with systemic lupus erythematosus. Our patient was a 27-year-old Persian/Caucasian male with fatigue, weakness, weight loss, abdominal distension, massive ascites, and normocytic hemolytic anemia. He did not mention any prior medical conditions and did not use any drugs. There were no signs of thyroid dysfunction, cardiac dysfunction, cancers, infectious diseases, hepatitis, kidney diseases, or other diseases. Low-gradient, high-protein ascites fluid, and positive antinuclear antibody and anti-double stranded DNA were in favor of systemic lupus erythematosus. Corticosteroid pulse therapy led to resolution of ascites, and the patient was discharged with prednisolone and hydroxychloroquine.
Peritonitis is a rare presentation of systemic lupus erythematosus, particularly as the first presentation and in the absence of other signs and symptoms; however, systemic lupus erythematosus should be considered as one the differential diagnoses for peritonitis when other etiologies have been ruled out.
系统性红斑狼疮是一种影响多个器官的炎症性疾病。浆膜炎是系统性红斑狼疮的一种表现，但腹膜炎是相对罕见的表现。特别是，观察到腹膜炎作为系统性红斑狼疮的首发表现是极其罕见的。
在这里，我们报告了一例无系统性红斑狼疮其他症状的腹膜炎患者，该患者最终被诊断为系统性红斑狼疮。我们的患者是一名 27 岁的波斯/高加索男性，表现为疲劳、虚弱、体重减轻、腹胀、大量腹水和正细胞正色素性溶血性贫血。他没有提到任何既往病史，也没有使用任何药物。没有甲状腺功能障碍、心脏功能障碍、癌症、传染病、肝炎、肾脏疾病或其他疾病的迹象。低梯度高蛋白腹水、抗核抗体和抗双链 DNA 阳性均支持系统性红斑狼疮的诊断。皮质类固醇脉冲治疗导致腹水消退，患者出院时给予泼尼松龙和羟氯喹。
腹膜炎是系统性红斑狼疮的一种罕见表现，特别是作为首发表现且无其他体征和症状时；然而，当排除其他病因后，应将系统性红斑狼疮作为腹膜炎的鉴别诊断之一。
