Gastrointestinal and hepatobiliary manifestations in systemic lupus erythematosus.

OBJECTIVE: To report GI and Hepatobiliary manifestations in SLE from Chulalongkorn Hospital in the year 2000. MATERIAL AND METHOD: A retrospective study of SLE patients in the Rheumatological Clinic, Medical Department, Chulalongkorn University. RESULTS: A total 225 SLE patients were found being mainly female (93.3%). The mean age was 32.13 +/- 11.65 years and they almost all lived in the central part of Thailand (79.1%). At diagnosis, the majority of SLE cases are active vital organ (72.1%), kidney and central nervous system are the main organ of involvement. GI and hepatobiliary manifestations were found in 32.89% but did not lead to SLE diagnosis. The duration between SLE diagnosis and first GI and hepatobiliary manifestations is 4.6 +/- 4.4 years. The 3 common manifestations are abnormal liver function test, diarrhea and abdominal pain, with the prevalance rate of 34, 17 and 11% respectively. CONCLUSION: GI and hepatobiliary manifestations of SLE patients in Chulalongkorn Hospital were found in 32.89% but were not specific and could be found in any part of the alimentary tract. The 3 common manifestations were abnormal liver function tests, diarrhea and abdominal pain which were not specific enough to diagnose SLE.

D-xylose absorption in non-chronic diarrhea AIDS patients with the wasting syndrome.

OBJECTIVE: To compare the intestinal absorptive capacity, permeability function and duodenal histopathology in human immunodeficiency virus (HIV) patients with or without wasting syndrome who had not suffered from chronic diarrhea. METHOD: Adult HIV patients who attended Chulalongkorn Hospital were included. The subjects were classified into wasting and non-wasting groups (group I and group II). 25 g oral D-xylose test, oral phenolsulfonephthalein test and duodenal histopathology were performed. RESULTS: Of thirty-two HIV patients, aged between 25-50 years enrolled, there were 18 and 14 patients in group I and group II, respectively. In both groups, the baseline data, permeability function and histopathology were similar. Intestinal absorptive capacity was statistically different, i.e. 5-hour urine D-xylose was 3.96 +/- 2.81 g and 5.95 +/- 2.47 g in group I and group II respectively (p < 0.05). CONCLUSION: This study demonstrated that D-xylose absorption was decreased in non-diarrheal, wasting HIV infected patients. Abnormal absorptive capacity is a common phenomenon found in HIV patients with wasting syndrome as determined by standard 25 g oral D-xylose test.