A Case of Systemic Lupus Erythematosus Initially Presented with Acute Acalculous Cholecystitis

Choi, Yun Jung; Yoon, Ha Yong; Jang, Seol A; Hong, Myong Joo; Lee, Won Seok; Yoo, Wan‐Hee

doi:10.4078/jrd.2014.21.3.140

Cited by 7 publications

(10 citation statements)

References 6 publications

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“…Generally, three prevailing therapies are considered for AAC: cholecystectomy, laparoscopic cholecystectomy, and percutaneous cholecystostomy (1,28). For SLE-associated AAC, corticosteroid therapy was successfully used in some reports as a conservative therapy (34)(35)(36)(37)(38). In previous reports of SLE-associated AAC conservatively treated with corticosteroids, antibiotics or immunosuppressive agents were used in combination with corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

“…Serositis and mesenteric inflammatory veno-occlusive disease (MIVOD) are also reported as possible pathogeneses of AAC (32,33). Corticosteroids have been successfully used in some cases as a conservative therapy for SLE-associated AAC (34)(35)(36)(37)(38). However, only a few reports have examined effective drugs for use in combination with corticosteroids.…”

Section: Disorders Of the Cardiovascular System And Hemodynamicsmentioning

confidence: 99%

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Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine

Kudo

Takaoka²,

Shimomura³

et al. 2019

Intern. Med.

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A 69-year-old Japanese woman was transferred to our hospital due to pancytopenia with a fever. She had Murphy's sign, and computed tomography showed pleural effusion and a swollen gallbladder without gallstones. We diagnosed her with systemic lupus erythematosus (SLE)-associated acute acalculous cholecystitis (AAC). Partly because her clinical and laboratory findings were not serious enough to warrant immediate surgical intervention, and partly because her poor general condition made her ineligible for surgery, surgical therapy was not selected. Corticosteroid therapy was performed with azathioprine, and the swelling in her gallbladder improved. As a conservative therapy for SLE-associated AAC, corticosteroid therapy combined with azathioprine might be beneficial.

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Section: Discussionmentioning

confidence: 99%

Section: Disorders Of the Cardiovascular System And Hemodynamicsmentioning

confidence: 99%

Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine

Kudo

Takaoka²,

Shimomura³

et al. 2019

Intern. Med.

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“…The classic histological feature of cholecystitis in SLE is vasculitis of small vessel arteries and venules. Associated findings may include atrophy and degeneration of the media of small arteries, fibrinoid necrosis of the vessel walls, old thrombosis, phlebitis and monocyte infiltrate in the lamina propria [2] . Although vasculitis is a common complication of SLE, manifesting in up to 18% of patients, it is usually a cutaneous disease [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic therapy with nasobiliary drainage is a third option for patients who cannot tolerate either surgery or cholecystostomy [5] . High-dose steroid therapy has been reported to be successful in a few cases and can be tried in selected patients, depending on general condition, disease severity and associated risk factors [1,2] . This case posed a diagnostic challenge.…”

Section: Discussionmentioning

confidence: 99%

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Acute Acalculous Cholecystitis as a Presenting Manifestation in Systemic Lupus Erythematosus

Mohapatra

Goldstein

Kumar

et al. 2016

European Journal of Case Reports in Internal Medicine

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Systemic lupus erythematosus (SLE) is known to involve the gastrointestinal tract, but gallbladder involvement is rare. The authors report the case of a 26-year-old postpartum female who presented with acute right upper quadrant abdominal pain and was diagnosed with acute acalculous cholecystitis (AAC). In the presence of concomitant features of nephritis, pericardial effusion, anaemia and positive ANA titre,

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C-reactive protein in gallbladder diseases: diagnostic and therapeutic insights

et al. 2020

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The gallbladder is an important component of the hepatobiliary system whose primary function is to aid in digestion of foodstuffs, excretion of drugs and facilitate removal of waste products from the body. The gall bladder is principally a storage organ for bile, chemically modified salts and acids of cholesterol which are synthesized in the liver and which function as surfactants to solubilize fatty substances of limited aqueous solubility. Any disruption in the amount or activity of bile surfactant can lead to an accumulation of insoluble molecular clumps (e.g., gallstones) that deposit in and obstruct fluid movement within the gallbladder, and which can lead to pathological congestion and tissue damage. The natural host defense response to any event that causes tissue damage is to stimulate inflammation, which non-specifically but aggressively reacts to the stimuli so to remove the cause and repair damaged tissues. The C-reactive protein (CRP) is a primarily hepatically produced serum protein whose blood levels increase within 6-10 h of any tissue-damaging event. The extent with which it increases correlates with the level of tissue damage and associated inflammation. CRP levels are reported to be of value in diagnosing acute cholecystitis severity, in predicting the outcome and prognosis of cancerassociated gallbladder resection, and in helping identify cystic structures during emergency laparoscopic cholecystectomies. As an understanding of distinctive CRP structural isoforms is evolving, its role not only as a biomarker but as regulator of both physiologic and pathophysiologic processes of inflammation may be relevant in the understanding of and treatment approaches for gallbladderassociated disease.

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A Case of Systemic Lupus Erythematosus Initially Presented with Acute Acalculous Cholecystitis

Cited by 7 publications

References 6 publications

Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine

Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine

Acute Acalculous Cholecystitis as a Presenting Manifestation in Systemic Lupus Erythematosus

C-reactive protein in gallbladder diseases: diagnostic and therapeutic insights

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