Clinical dilemma of acute abdomen in patients with systemic lupuserythematosus: A case report

Abstract

Gastrointestinal (GI) symptoms and signs may be seen in approximately one third of patients with rheumatologic disorders as primary presentation. Some of these findings may be nondiagnostic and may be clinical diagnostic challenge. GI tract involvement by systemic lupus erythematosus (SLE) must be differentiated from adverse drug reactions of treatment agents. Abdominal pain, associated with nausea and vomiting, is seen in up to 30 percent of patients with SLE. The cause of abdominal pain does not differ significantly from that in patients without lupus. Special attention should be given to conditions that may accompany lupus such as lupus peritonitis and infection. Lupus peritonitis is very unusual clinical finding and it is worth reporting. Our patient was a young female with definite rheumatologic disorders with acute abdomen as the dominant clinical finding. Imaging findings confirmed peritoneum and small intestine involvement. Paraclinical work-up including blood analysis confirmed SLE. She was managed with prednisone and non-steroidal anti-inflammatory agents, and discharged with partial improvement. This case report shows that patients with symptoms consistent with acute abdomen in SLE remind us a clinical dilemma. There have been few reports of acute abdomen in patients with SLE in the literature. And more case reports are needed.

Pseudo‐pseudo Meigs syndrome in systemic lupus erythematosus misdiagnosed as pseudo‐Meigs' syndrome: A case report

“…When ascites is present, other causes of ascites, such as congestive heart failure, constrictive pericarditis, nephrotic syndrome and lupus‐related hypoproteinemia should be excluded 8 . In our case, the cardiac ultrasound was normal and the ejection fraction was within the normal range, excluding the possibility of congestive heart failure and constrictive pericarditis.…”