Rheumatology Department, Clínica Imbanaco, Grupo Quirónsalud, Cali, Colombia.
Louise Coote Lupus Unit, Guy's Hospital, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK.
Rheumatology (Oxford). 2024 May 3;63(6):1494-1501. doi: 10.1093/rheumatology/kead689.
Lupus enteritis (LE) is a rare manifestation of systemic lupus erythematosus. The pathophysiology of LE has not been fully elucidated, although inflammatory and thrombotic processes are likely important factors. The underlying pathophysiological mechanisms may depend on which portion of the intestine is affected. Over half of the patients with LE also present with renal or haematological complications. The diagnosis of LE is based on clinical, histopathological and imaging findings; abdominal computed tomography (CT) is the gold standard in diagnosis. Abdominal CT can also identify factors that predict complications and could potentially guide pharmacological and nutritional management. Timely identification and prompt treatment initiation are paramount to avoid life and organ threatening complications. Glucocorticoids are often the first-line treatment. Additional therapy including immunosuppressive therapy is utilised on a case-by-case basis as there are no clinical trials to define the optimal therapeutic approach. Surgical intervention may be needed especially if there is bowel perforation or peritonitis. In general, the prognosis of LE is good.
狼疮性肠炎（LE）是系统性红斑狼疮的一种罕见表现。尽管炎症和血栓形成过程可能是重要因素，但 LE 的病理生理学尚未完全阐明。潜在的病理生理机制可能取决于受影响的肠道部位。超过一半的 LE 患者还存在肾脏或血液学并发症。LE 的诊断基于临床、组织病理学和影像学发现；腹部计算机断层扫描（CT）是诊断的金标准。腹部 CT 还可以识别预测并发症的因素，并可能有助于指导药物和营养管理。及时识别和及时开始治疗对于避免危及生命和器官的并发症至关重要。糖皮质激素通常是一线治疗。根据具体情况使用额外的治疗方法，包括免疫抑制治疗，因为没有临床试验来定义最佳治疗方法。如果发生肠穿孔或腹膜炎，可能需要手术干预。一般来说，LE 的预后良好。
