A clinical analysis of 36 cases of systemic lupus erythematosus with lupus mesenteric vasculitis / 中华风湿病学杂志

ABSTRACT

Objective To analyze the clinical profiles of lupus mesenteric vasculitis (LMV).Methods Thirty-six SLE patients diagnosed with LMV and 72 SLE patients (12) without LMV at West China Hospital between October 2009 and January 2012 were enrolled.The imaging,clinical manifestation,laboratory examinations data were analyzed retrospectively.Quantitative differences were analyzed by the Student's t and Z tests and qualitative data were compared with Chi-square.P value less than 0.05 was considered as statistically significant.Results ① The prevalence of LMV in patients with SLE was 1.2％(36/3 051),while 47％(17/36) as the initial symptom of SLE.Thirty-six LMV patients were all female.The prevalence of abdominal pain was 78％(28/36),nausea or vomitting was 58％(21/36),abdominal distension was 50％(18/36),diarrhea was 47.2％ (17/36),intestinal perforation was 3％ (1/36) and incomplete obstruction was 8％ (3/36).Enhanced CT scan showed 81％(25/31) patients suffered from intestinal dilation and (or) mesenteric edema;SLEDAI (17±5),C3 (0.44±0.25) g/L,C4 (0.10±0.09) g/L,Z value on above items were 4.30,-3.85 and-2.94 respectively compared to SLE patients without LMV,and all P＜0.05,the differemces were significant.In addition,Also,the proportion of ANA and anti-ENA antibody showed no significant difference.68.6％(13/36) patients were also diagnosed with lupus nephritis;61％(22/36) patients were treated with methylprednisolone more than 200 mg/d resulting in relief of symptom.Conclusion Female patients with SLE may be more likely to suffer from LMV;Enhanced abdominal CT scan is still essential to the diagnosis of LMV.LMV is correlated with urinary system malfunction.LMV always occurs in active lupus with low C3 and C4 level.More than half patients should be treated with corticosteroid and cyclophosphamide pulse therapy.