28 Visceral pseudo-obstruction (VPO): a new terminology of systemic lupus erythematosus gastrointestinal involvement and a CT scoring system

Chen, Zhiwei; Li, Jiaoyu; Wang, Xiaodong; Li, Ting; Ye, Shuang

doi:10.1136/lupus-2019-lsm.28

Abstracts 2019

DOI: 10.1136/lupus-2019-lsm.28

|View full text |Cite

28 Visceral pseudo-obstruction (VPO): a new terminology of systemic lupus erythematosus gastrointestinal involvement and a CT scoring system

Zhiwei Chen

Jiaoyu Li

Xiaodong Wang

et al.

Abstract: Methods Patients with SLE gastrointestinal involvement from two independent retrospective cohorts were included in our study. All patients fulfilled the ACR 1997 revised classification criteria for SLE. CT scan at least once is necessary prior to glucocorticoid treatment in all enrolled patients. The primary endpoint was set to time to GI functional recovery, defined as intake 50% ideal calories POPO50. A new CT scoring system for SLE-VPO was established in the derivation cohort and validated in the validation… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2020

Publication Types

Select...

Article1

Relationship

Self Cite1

Independent0

Authors

Journals

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anatomical distribution of SLE-VPO involvements (Part of the data was presented as a poster in Lupus Conference 201932 ).Anatomical sites affectedScore (total score* = 12)Thickness of bowel walls ≤3.0 mm, 0; 3.1-7.9 mm, 1; ≥8.0 mm,…”

mentioning

confidence: 99%

Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Chen

Zhou

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLe) gastrointestinal (Gi) complication is characterized by multisegment and multi-compartment involvement. The aim of this study is to develop a computed tomography (CT) image-based system for disease evaluation. SLE patients with GI involvement from two independent cohorts were retrospectively included. Baseline abdominal ct scan with intravenous and oral contrast was obtained from each individual. A CT scoring system incorporating the extent of GI tract involvement and intestinal wall thickness, along with extra-GI compartment involvement, was developed and validated. The outcome measurement was the time to GI functional recovery, defined as the time to tolerable per os (po) intake ≥50% of ideal calories (PO50). A total of 54 and 37 patients with SLE GI involvement were enrolled in the derivation and validation cohorts, respectively. The CT scores for SLE GI involvement were positively correlated with patients' time to PO50 (r = 0.57, p < 0.0001, derivation cohort; r = 0.42, p = 0.0093, validation cohort). Patients with a CT score ≤ 3 had a shorter time to PO50 (median time of 0 day) in pooled cohort, whereas those with a CT score > 3 incurred a significantly prolonged recovery with a median time to PO50 of 13 days (p < 0.0001). The CTbased scoring system may facilitate more accurate assessment and individualized management of SLE patients with Gi involvement. Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with multi-system involvement 1. Gastrointestinal (GI) manifestations are commonly presented in up to 50% of SLE patients 2 , with 2-30% of these cases attributed to active SLE per se 3 ; whereas others may due to treatment side effects or co-morbidities. Several key questions remain undetermined concerning active SLE GI involvement. First, multiplicity of its terminology, such as GI vasculitis (mesenteric vasculitis), lupus gastroenteritis (lupus enteritis) and intestinal pseudo-obstruction (IPO) 4-7 , implies the uncertainty of the underlying pathophysiology. Second, specific assessment tools for its activity, severity and outcome are lacking. As an example, none of the clinical features of SLE GI involvement is captured by the widely used SLE disease activity index (SLEDAI). It is noteworthy that computed tomography (CT) imaging has been well accepted in the evaluation of SLE GI involvement. Certain characteristic radiographic features 8,9 , such as 'target sign' (intestinal wall edema and thickening), 'comb sign' (enhanced engorgement of mesenteric vasculature), extra-GI compartment involvement (gallbladder wall thickening, interstitial cystitis, dilatation of urinary tract and biliary-pancreatic duct), have been described. However, image-based, prognosis-relevant measurable tools are yet to be developed. Third, the current treatment, particularly nutritional protocol for SLE patients with GI involvement, are merely empirical. Although the overall outcome is relatively benign 10 , some patients may suffer from a prolonged GI insufficiency, and some may...

show abstract

mentioning

confidence: 99%

Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Chen

Zhou

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

28 Visceral pseudo-obstruction (VPO): a new terminology of systemic lupus erythematosus gastrointestinal involvement and a CT scoring system

Cited by 1 publication

References 0 publications

Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Contact Info

Product

Resources

About