Acute Acalculous Cholecystitis as a Presenting Manifestation in Systemic Lupus Erythematosus

Mohapatra, Sonmoon; Goldstein, Debra; Kumar, Akshat; Saha, Trisha; Penigalapati, Damodar

doi:10.12890/2016_000408

Cited by 2 publications

(4 citation statements)

References 4 publications

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“…Moreover, AAC patients suffering from acute abdominal symptoms caused by active rheumatic disease might not be fully relieved by cholecystectomy, instead requiring steroid treatment. [38,53,77] AAC is heterogenous, with various pathophysiologies, prognoses, and complications requiring different treatment strategies. The pathogenesis of AAC is usually attributed to bile stasis, gallbladder ischemia, or inflammation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…After identifying 671 articles, 153 articles involving 171 cases were eligible: 104 viral infection and 67 rheumatic disease AAC patients. [8,11–162] Viral infection types included: Epstein Barr virus, hepatitis virus, dengue virus, SARS-CoV-2 (COVID-19), human immunodeficiency virus, and cytomegalovirus. Rheumatic diseases included: systemic lupus erythematosus, adult-onset Still disease, Henoch-Schönlein purpura, polyarteritis nodosa, Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis), microscopic polyangiitis, temporal arteritis, Wegener granulomatosis (granulomatosis with polyangiitis), Kawasaki syndrome, systemic juvenile idiopathic arthritis, and juvenile dermatomyositis (Table 1).…”

Section: Methodsmentioning

confidence: 99%

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Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

Chang,

Wang,

Shi

et al. 2023

Medicine

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Patients with acute acalculous cholecystitis (AAC) often present with acute abdominal symptoms. However, recent clinical studies have suggested that some patients with AAC and an acute abdomen, especially when caused by viruses or rheumatic disease, may not require cholecystectomy and that conservative treatment is adequate. Whether cholecystectomy is superior to conservative treatment for patients with AAC presenting with a severe acute abdomen is still uncertain. This was a case series study of AAC-related literature published between 1960 and 2022. In total, 171 cases (104 viral infection-associated AAC and 67 rheumatic disease-associated AAC) were included. The prognoses of patients receiving cholecystectomy or conservative treatment were compared. To account for confounding factors, etiological stratification and logistic regression were performed. The prognosis was similar for patients undergoing cholecystectomy and conservative treatment (P value .364), and virus infection-associated AAC had a better prognosis than rheumatic disease-associated AAC (P value .032). In patients with AAC caused by viruses or rheumatic disease, the acute abdomen can be adequately managed by conservative treatment of the underlying etiology and does not mandate surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

Chang,

Wang,

Shi

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…The diagnosis of AAC is made by abdominal ultrasound, which will show a significance for gallbladder wall thickening more than 3 cm and pericholecystic fluid without any gallstones identified [16]. In most of the cases, steroids are the first choice of treatment.…”

Section: Discussionmentioning

confidence: 99%

Polyserositis and Acute Acalculous Cholecystitis: An Uncommon Manifestation of Undiagnosed Systemic Lupus Erythematosus

Obreja

Salazar

Torres

2019

Cureus

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Systemic lupus erythematosus (SLE) is a common systemic disease in the rheumatologic field. Serositis and gastrointestinal symptoms are common manifestations of SLE; however, polyserositis concurrently with acute acalculous cholecystitis is a rare and usually underestimated entity that can be associated with SLE. Medical treatment with steroids is efficacious and, in most instances, cholecystectomy can be avoided. We present the case of a young female patient with polyserositis and acute acalculous cholecystitis secondary to undiagnosed SLE, who eventually required surgical laparoscopic intervention and improved with immunosuppressive treatment.

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Acute Acalculous Cholecystitis as a Presenting Manifestation in Systemic Lupus Erythematosus

Cited by 2 publications

References 4 publications

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

Polyserositis and Acute Acalculous Cholecystitis: An Uncommon Manifestation of Undiagnosed Systemic Lupus Erythematosus

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