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A case of systemic lupus erythematosus presenting with intestinal lymphangiectasia-associated protein-losing enteropathy accompanying hyperinflammation.
Bektas, Murat; Tas, Oguzhan; Ordu, Melike.
  • Bektas M; Division of Rheumatology, Department of Internal Medicine, Aksaray Training and Research Hospital, Aksaray, Turkey.
  • Tas O; Department of General Surgery, Aksaray Training and Research Hospital, Aksaray, Turkey.
  • Ordu M; Department of Pathology, Aksaray Training and Research Hospital, Aksaray, Turkey.
Int J Rheum Dis ; 26(3): 591-598, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2251694
ABSTRACT
Systemic lupus erythematosus (SLE) has the potential to affect virtually every organ; however, gastrointestinal system manifestations are relatively rare compared to other autoimmune diseases such as systemic sclerosis and inflammatory bowel disease. A 29-year-old female patient attended to the emergency room with abdominal distention, acute onset abdominal pain and constipation. She had watery chronic diarrhea (4-5 times/d) and weight loss (6 kg, 12%) for 4 months. While there was increased intestinal wall thickness, air-liquid levels were shown on abdomen computed tomography scan. The patient underwent abdominal surgery due to diagnosis of ileus. Ileocecal resection was performed and pathologic evaluation revealed intestinal lymphangiectasia. Autoimmune serology was performed with the following resulats anti-nuclear antibody 1/3200 with homogenous pattern, anti-DNA antibody and anti-Sm/ribonucleoprotein antibodies were positive in addition to low complement levels (C3 0.28 [0.9-1.8 g/L], C4 0.06 [0.1-0.4 g/L]) indicating diagnosis of SLE. Development of intestinal involvement in SLE (lupus enteritis) is mainly grouped into 3 headings such as mesenteric vasculitis, pseudo-obstruction, and protein-losing enteropathy. Although the pathogenesis of intestinal lymphangiectasia remains unknown, it has been reported that immune complex-mediated visceral vasculitis may result in bowel wall and mucosal edema. To our knowledge this is the first case report accompanying hyperinflammatory response in addition to intestinal lymphangiectasia in SLE. On the other hand, clinicians should be alert for other reasons for hyperinflammatory syndromes rather than COVID-19, even during the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein-Losing Enteropathies / Giant Cell Arteritis / Granulomatosis with Polyangiitis / COVID-19 / Lupus Erythematosus, Systemic Type of study: Case report / Diagnostic study / Experimental Studies Topics: Long Covid Limits: Adult / Female / Humans Language: English Journal: Int J Rheum Dis Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: 1756-185X.14541

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Protein-Losing Enteropathies / Giant Cell Arteritis / Granulomatosis with Polyangiitis / COVID-19 / Lupus Erythematosus, Systemic Type of study: Case report / Diagnostic study / Experimental Studies Topics: Long Covid Limits: Adult / Female / Humans Language: English Journal: Int J Rheum Dis Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: 1756-185X.14541