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系统性红斑狼疮腹痛的罕见表现:狼疮性小肠结肠炎病例报告

A Rare Manifestation of Abdominal Pain in Systemic Lupus Erythematosus: A Case Report on Lupus Enterocolitis.

作者信息

Vaughan-Williams William, Jerry Akhil, Youssef Michael, Samani Syazeddy

机构信息

Internal Medicine, University Hospitals Birmingham National Health Service (NHS) Foundation Trust-Queen Elizabeth Hospital, Birmingham, GBR.

Radiology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust-Queen Elizabeth Hospital, Birmingham, GBR.

出版信息

Cureus. 2025 Apr 21;17(4):e82750. doi: 10.7759/cureus.82750. eCollection 2025 Apr.

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease that commonly affects the skin, kidneys, and musculoskeletal system. We present a case of lupus enterocolitis, a rare manifestation of SLE that affects the small and large bowel. The case involves a 17-year-old woman with SLE, presenting with a seven-day history of colicky abdominal pain, nausea, and vomiting. A contrast-enhanced CT abdomen and pelvis were organised 48 hours into her admission, showing multifocal inflammatory changes in the small and large bowel, most prominent in the ascending and transverse colon. She was successfully treated with intravenous steroids and continuation of her immunosuppressive agents. This case illustrates that SLE can affect the bowel, leading to an acute abdominal presentation that is difficult to diagnose. Prompt imaging and early administration of intravenous steroids enable effective management of lupus enterocolitis, reducing the risk of life-threatening complications such as bowel ischaemia and perforation.

摘要

系统性红斑狼疮(SLE)是一种自身免疫性疾病,通常会影响皮肤、肾脏和肌肉骨骼系统。我们报告一例狼疮性小肠结肠炎病例,这是SLE的一种罕见表现,会影响小肠和大肠。该病例为一名17岁的SLE女性患者,有七天的绞痛性腹痛、恶心和呕吐病史。入院48小时后进行了腹部和盆腔增强CT检查,显示小肠和大肠有多灶性炎症改变,在升结肠和横结肠最为明显。她通过静脉注射类固醇和继续使用免疫抑制剂得到了成功治疗。该病例表明SLE可累及肠道,导致难以诊断的急性腹部表现。及时进行影像学检查并早期静脉注射类固醇能够有效管理狼疮性小肠结肠炎,降低诸如肠缺血和穿孔等危及生命并发症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab85/12095892/e20335bc395d/cureus-0017-00000082750-i01.jpg

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