Extensive Enteritis with Rapid Onset of Massive Ascites as the Initial Presentation of Systemic Lupus Erythematosus

Bae,  Joong Gi; Jung,  Hyun Chul; Choi,  Seung Won; Park,  Bong Hee; Kim,  Sun Hyu; Hong,  Eun Seog

J Korean Soc Emerg Med > Volume 23(2); 2012 > Article

Case Report

Journal of The Korean Society of Emergency Medicine 2012;23(2): 284-287.

Extensive Enteritis with Rapid Onset of Massive Ascites as the Initial Presentation of Systemic Lupus Erythematosus

Joong Gi Bae, Hyun Chul Jung, Seung Won Choi, Bong Hee Park, Sun Hyu Kim, Eun Seog Hong

¹Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea. choisw@uuh.ulsan.kr
²Department of Pathology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea.
³Department of Emergency Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea.

ABSTRACT

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disorder with protean manifestations. However, compared with articular, cutaneous, or renal involvement, gastrointestinal symptoms are far less common and are particularly unusual for the initial presentation of SLE. Gastrointestinal manifestations range from mild nonspecific symptoms to serious life-threatening complications, such as mesenteric vasculitis, intestinal pseudoobstruction, acute pancreatitis, and protein-losing enteropathy. Therefore, in order to improve the prognosis, early diagnosis and timely treatment are important. We describe a 45-year-old female patient who presented with extensive enteritis and peritonitis as the initial manifestation of SLE. Symptoms at presentation included severe abdominal pain and rapid development of massive ascites. After administration of high-dose corticosteroid therapy, her symptoms showed prompt improvement.

Key words: Systemic lupus erythematosus, Enteritis, Peritonitis, Acute abdomen