A Case of Systemic Lupus Erythematosus Manifesting First as Mesenteric Vasculitis |
Gun Hwa Lee, Chang Soo Eun, June Seok Song, Il Hwan Oh, Suk Hyun Jung, Hye Sun Park, Yong Chul Jun, Ju Hyun Sohn, Dong Soo Han |
Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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창자간막 혈관염으로 처음 발현된 전신홍반루푸스 1예 |
이건화, 은창수, 송준석, 오일환, 정석현, 박혜선, 전용철, 손주현, 한동수 |
한양대학교 의과대학 구리병원 내과학교실 |
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Abstract |
Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease that manifests various symptoms. Mesenteric vasculitis (MV) is one of the serious complications of SLE and carries a high mortality rate. Although MV is the main cause for acute abdominal pain in patients with SLE, it is very rare for the pain to be the first clinical manifestation of the disease. A 34-year old female presented with sudden onset abdominal pain accompanied by small intestinal bowel edema observed on abdominal computed tomography. We performed a diagnostic laparoscopy, as vital signs were becoming unstable and the diffuse abdominal tenderness was worsening rapidly. The examination showed a severe jejunal infarction; thus, the patient underwent a small bowel segmental resection. A histological examination revealed multiple, hemorrhagic, small-vessel vasculitis, and later serologic autoimmune markers were consistent with SLE. We suggest that SLE be considered in the differential diagnosis of young females presenting with an acute abdomen and unexplained enteropathy. A surgical approach such as exploratory laparoscopy could be an option in search for the cause. (Intest Res 2012;10: 0-308) |
Key Words:
Mesenteric vasculitis, Acute abdomen, Systemic lupus erythematosus |
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