Clinico-Laboratory Features and Associated Factors of Lupus Mesenteric Vasculitis

Abstract

Introduction: Lupus mesenteric vasculitis (LMV) is a rare but potentially life-threatening clinical entity in systemic lupus erythematosus (SLE) patients. Objective: The present study was initiated to explore the clinical features and associated factors of LMV in SLE patients. Methods: We conducted a retrospective study on 50 cases of SLE patients with lupus mesenteric vasculitis (LMV) from January 2010 to December 2019 and 89 cases of non-LMV-SLE patients with similar demographic and comorbidities were included as control. All the data regarding clinical features, laboratory findings, and treatment were reviewed independently by two experts in the field. Both univariate and multivariate logistic regression analyses were employed to identify the associated factors of LMV. Results: The incidence of LMV was 2.9% among hospitalized SLE patients in the current study. The most frequent symptom and physical sign of LMV were respectively abdominal pain (48, 96%) and abdominal tenderness (45, 90%). Through univariate and subsequent multivariate analysis, oral ulcer (OR, 4.25; P = 0.024), urinary tract involvement (OR, 5.23; P = 0.021), and elevated D-dimer (OR, 1.121; P = 0.008) were demonstrated to be positively associated with LMV, while percentage of lymphocytes (OR, 0.928; P = 0.004) and complement 3 (OR, 0.048; P = 0.008) were negatively correlated with LMV. Conclusions: Oral ulcer, urinary tract involvement, reduced percentage of lymphocytes and complement 3, elevated D-dimer could be associated factors for LMV in SLE patients.

Clinical characteristics and prognosis of childhood-onset lupus mesenteric vasculitis as the initial presentation—a case–control study

“…We also found that cSLE with LMV often had decreased complement C3 and C4. There are similar findings in a paper: complement C3 and C4 are lower in LMV patients than in other SLE [ 8 ]. Therefore, clinicians should pay close attention to abdominal symptoms in cSLE.…”

“…In our study, all cSLE with LMV presented with intestinal wall thickening. The main pathological changes are intestinal wall edema and vascular inflammation, so a typical target sign or double loop sign can be presented on enhanced CT. Mesenteric vascular enhancement occurred in 6 cases in our study, presenting as a comb tooth sign, which is also a specific imaging manifestation in LMV [ 8 ]. We had 3 cases with intestinal congestion with liquid–gas level and diagnosed as intestinal obstruction, which improved after glucocorticoid treatment.…”

“…The SLEDAI-2 K score at onset was 19.45 points, indicating disease activity was very high. In 2021, Wang et al compared adult SLE with and without LMV and found that SLEDAI-2 K in patients with LMV was higher than that in patients without LMV [ 8 ]. In 2011, Tu et al compared the clinical characteristics of adult LMV and child LMV, and the study showed that the SLEDAI-2 K score of child LMV was higher than that of adult LMV patients, with a score of > 15 points [ 9 ].…”

Alterations and predictive value of blood routine parameters in patients with lupus enteritis: A retrospective study

“…Lee et al 2 reported a significant decrease in white blood cell (WBC) count among patients with LE, which exhibited a strong correlation with the presence of the disease. In contrast, Wang et al 3 observed no significant difference in WBC count between the LE and non-LE groups; however, they did report a notable reduction in lymphocyte count among patients with LE, indicating its potential diagnostic value. The red cell distribution width (RDW), Which is an indicator of chronic inflammation, has been demonstrated as a valuable marker for determining the activity of SLE.…”

“…Routine hematological parameters may exhibit alterations during the onset or active phase of the disease, and certain variations among these parameters could potentially serve as indicators for predicting the likelihood of LE onset. For instance, leukopenia 2 or lymphocytopenia 3 may suggest a higher probability of LE occurrence. NLR and PLR are indicators derived from routine blood parameters that offer greater utility in comprehending a patient's systemic inflammatory state due to their ability to integrate two distinct immune pathways.…”