Cheng Jirong, Wu Qian, Wu Qiurong, Peng Yuanhong
Department of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Br J Hosp Med (Lond). 2024 Jun 30;85(6):1-7. doi: 10.12968/hmed.2024.0108. Epub 2024 Jun 26.
Systemic lupus erythematosus (SLE) is a complex autoimmune disease where the body loses tolerance to its own antigens, particularly nuclear antigens. Abnormal responses from T and B cells lead to the production of autoantibodies and the formation of immune complexes in tissues, triggering complement activation, inflammation, and irreversible organ damage. SLE can affect any part of the body, resulting in diverse clinical symptoms. One rare manifestation of SLE is lupus mesenteric vasculitis (LMV), which presents with vague symptoms, abnormal laboratory findings, and specific imaging features. LMV, although uncommon, can progress to severe complications such as bowel perforation, haemorrhage, and even mortality. Here, we report a case of LMV with the involvement of multiple organ systems (including mucocutaneous, musculoskeletal, serosal cavities, and haematological systems), presenting initially with life-threatening intractable gastrointestinal bleeding, and complicated by severe pulmonary infection. By sharing this case, we aim to enhance clinicians' confidence in managing critical SLE cases and raise awareness about disease surveillance.
系统性红斑狼疮（SLE）是一种复杂的自身免疫性疾病，机体对自身抗原，尤其是核抗原失去耐受性。T细胞和B细胞的异常反应导致自身抗体的产生以及组织中免疫复合物的形成，从而引发补体激活、炎症和不可逆的器官损伤。SLE可累及身体的任何部位，导致多种临床症状。SLE的一种罕见表现是狼疮性肠系膜血管炎（LMV），其症状模糊、实验室检查结果异常且具有特定的影像学特征。LMV虽然不常见，但可进展为严重并发症，如肠穿孔、出血，甚至死亡。在此，我们报告一例累及多个器官系统（包括皮肤黏膜、肌肉骨骼、浆膜腔和血液系统）的LMV病例，最初表现为危及生命的顽固性胃肠道出血，并伴有严重肺部感染。通过分享该病例，我们旨在增强临床医生对重症SLE病例的管理信心，并提高对疾病监测的认识。
