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Lupus ; 21(4): 445-8, 2012 Apr.
Article in English | MEDLINE | ID: mdl-21997967

ABSTRACT

Protein-losing enteropathy is a rare manifestation of systemic lupus erythematosus. We report the case of an 18-year-old woman that presented initially with diarrhoea and anasarca. During evaluation, there was low serum albumin of 1.6 g/dl (3.5-5.2 g/dl) and a positive antinuclear antibody test (1:2560). Anti-Sm antibodies (ELISA) were positive in addition to low serum C3 of 35 mg/dl. A scintigraphy using 99mTc-labelled albumin was positive for abdominal protein loss. A diagnosis of systemic lupus erythematosus related protein-losing enteropathy was made. She was started on prednisolone 40 mg/day without amelioration; a month later, azathioprine (100 mg/day) was added, leading to normalization of serum albumin and resolution of symptoms within 4 months. After 1.5 years, the patient developed a 2.9 g 24-h proteinuria while still in remission of the protein-losing enteropathy, receiving 5 mg prednisone and 100 mg azathioprine daily.


Subject(s)
Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Protein-Losing Enteropathies/diagnosis , Protein-Losing Enteropathies/etiology , Adolescent , Antibodies, Antinuclear/blood , Azathioprine/therapeutic use , Biomarkers/blood , Complement C3/analysis , Diarrhea/etiology , Drug Therapy, Combination , Edema/etiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Hypoalbuminemia/etiology , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/drug therapy , Lupus Nephritis/etiology , Prednisolone/therapeutic use , Prednisone/therapeutic use , Protein-Losing Enteropathies/blood , Protein-Losing Enteropathies/drug therapy , Proteinuria/etiology , Serum Albumin/analysis , Time Factors , Treatment Outcome
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