Cook Samuel G
Internal Medicine, Wright State University Boonshoft School of Medicine, Dayton, USA.
Cureus. 2022 Mar 16;14(3):e23231. doi: 10.7759/cureus.23231. eCollection 2022 Mar.
Although systemic lupus erythematosus (SLE) can manifest differently in each patient, ascites is a rare first sign. The diagnosis of SLE can be easily missed when the initial presentation is uncommon. A 39-year-old male presented with painless abdominal fullness and was found to have ascites, thrombocytopenia, and anemia. He was initially diagnosed with Evan's syndrome and treated with prednisone. Upon follow-up, he had worsening thrombocytopenia and was found to have a positive antinuclear antibody, anti-double-stranded DNA antibody, and low complement levels consistent with SLE. He was treated with methylprednisolone, intravenous immunoglobulin, and mycophenolate mofetil with improvement.
虽然系统性红斑狼疮（SLE）在每个患者身上的表现可能不同，但腹水是一种罕见的首发症状。当初始表现不常见时，SLE的诊断很容易被漏诊。一名39岁男性因无痛性腹部胀满就诊，检查发现有腹水、血小板减少和贫血。他最初被诊断为伊文氏综合征，并接受泼尼松治疗。随访时，他的血小板减少情况恶化，发现抗核抗体、抗双链DNA抗体阳性，补体水平低，符合SLE表现。他接受了甲泼尼龙、静脉注射免疫球蛋白和霉酚酸酯治疗后病情好转。
