Aftab Adan, Saleem Nida, Abbas Syed Farhat, Ullah Zafar, Haneef Muhammad
Shifa International Hospital, H-8/4, Pitras Bukhari Road, Islamabad, Pakistan.
Case Rep Gastrointest Med. 2022 Jun 6;2022:3443141. doi: 10.1155/2022/3443141. eCollection 2022.
Although lupus enteritis is a rare manifestation of systemic lupus erythematosus yet results in significant distress. This disorder contributes to diagnostic and therapeutic dilemma leading to enhanced mortality. . We report a case history of a 29-year-old female who presented with severe abdominal pain, watery stools, and vomiting, and later on, she developed pancytopenia and renal impairment. On intensive workup, diagnosis of lupus-associated enteritis, nephritis, and pancytopenia was discovered. She improved drastically on initiation of plasmapheresis followed by low-dose intravenous rituximab. One year posttreatment, she remained in complete remission.
From this case, it can be suggested that in a young female with intractable abdominal pain, the remote possibility of lupus enteritis must be kept in mind. Besides this, plasmapheresis can have a potential role in refractory lupus enteritis. Furthermore, low-dose intravenous rituximab can be a safe and cost-effective treatment option in achieving sustained remission of clinical and laboratory parameters in lupus enteritis.
尽管狼疮性肠炎是系统性红斑狼疮的一种罕见表现，但会导致严重不适。这种病症会造成诊断和治疗困境，进而增加死亡率。我们报告一例29岁女性的病史，该患者出现严重腹痛、水样便和呕吐，随后出现全血细胞减少和肾功能损害。经过全面检查，发现患有狼疮相关性肠炎、肾炎和全血细胞减少。在开始进行血浆置换并随后使用低剂量静脉注射利妥昔单抗后，她的病情大幅改善。治疗一年后，她仍处于完全缓解状态。
从该病例可以看出，对于患有顽固性腹痛的年轻女性，必须考虑到狼疮性肠炎这种罕见可能性。除此之外，血浆置换在难治性狼疮性肠炎中可能具有潜在作用。此外，低剂量静脉注射利妥昔单抗在实现狼疮性肠炎临床和实验室指标的持续缓解方面可能是一种安全且经济有效的治疗选择。
