Fatal evolution of systemic lupus erythematosus associated with Crohn's disease
Arq. gastroenterol
;
37(4): 224-6, out.-dez. 2000.
Article
in English
| LILACS
| ID: lil-286404
RESUMO
Abstract The authors describe the case of a young Brazilian woman who was treated of ileocolonic Crohn's disease sparing rectum, as confirmed by colonoscopy and histopathological examination. After a 4-years course of sulfasalazine treatment, she presented with skin facial lesions in vespertilio, fever, arthralgias and high titers of anti-ANA and LE cells. A sulfasalazine-induced lupus syndrome was diagnosed, because ofter sulfasalazine withdrawal and a short course of prednisone, the clinical symptoms disappeared and the laboratory tests returned to normal. Mesalazine 3 g/day was started and patient remained well for the next 3 years, when she was again admitted with fever, weakness, arthralgias, diplopy, strabismus and hypoaesthesia in both hands and feet, microhematuria, haematic casts, hypocomplementemia and high titers of autoimmune antibodies. A diagnosis of associated systemic lupus erythematosus was made. Although a pulsotherapy with methylprednisolone was started, no improvement was noticed. A cyclophosphamide trial was tried and again no positive results occurred. The patient envolved to severe clinical manifestation of general vasculitis affecting the central and peripheral nervous system and lungs, havaing a fatal evolution after 2 weeks. Although uncommon, the association of both disease may occur, and the authors call attention to this possibiliti, making a brief review of literature.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Sulfasalazine
/
Crohn Disease
/
Anti-Inflammatory Agents, Non-Steroidal
/
Mesalamine
/
Lupus Erythematosus, Systemic
Type of study:
Risk factors
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Arq. gastroenterol
Journal subject:
Gastroenterology
Year:
2000
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Juiz de Fora University/BR
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