Ischemic colitis associated with intestinal vasculitis: Histological proof in systemic lupus erythematosus

Lee, Jeong Rok; Paik, Chang Nyol; Kim, Jin-Dong; Chung, Woo Chul; Lee, Kang-Moon; Yang, Jin Mo

doi:10.3748/wjg.14.3591

Cited by 24 publications

(22 citation statements)

References 10 publications

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“…Diagnostic angiography has been utilized previously in the detection of large and small vessel disease related to SLE vasculitis [5]. Previous cases of vasculitis-related colitis have pointed to the relative sparing of the rectum and this has been postulated to be the result of the rectum’s redundancy in vascularization [6, 7]. The current case is unique as only the rectum was involved.…”

Section: Discussionmentioning

confidence: 93%

“…Few cases of SLE-related rectal necrosis exist in the literature; treatment is often determined by clinical progression. Cases of ischaemic colitis managed with steroids and non-operative management have been described [6]. However, in the current case, the extent of necrosis and progressive sepsis required aggressive and expedient surgical control.…”

Section: Discussionmentioning

confidence: 95%

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A rare case of lupus-related gastrointestinal vasculitis presenting as rectal gangrene

Liang

Khoury

2019

Journal of Surgical Case Reports

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Systemic lupus erythematosus (SLE) related gastrointestinal vasculitis is a rare condition limited to case studies within the literature however, no cases of rectal gangrene and perforation have been previously described. A 32-year-old male presented with abdominal pain, vomiting and fevers. CT demonstrated free gas and free fluid around the rectum indicative of a perforation. He proceeded to urgent laparotomy, confirming a diagnosis of rectal infarction and perforation. Uniquely, the involved segment of gangrene extended from the rectosigmoid to the anorectal junction. A Hartmanns procedure was performed. Histopathology confirmed underlying stenosis of the rectal arteries secondary to chronic vasculitis related to the affected areas. The current case is a unique presentation of SLE-related vasculitis. It highlights the need to judiciously investigate SLE patients presenting with surgical acute abdomen.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 95%

A rare case of lupus-related gastrointestinal vasculitis presenting as rectal gangrene

Liang

Khoury

2019

Journal of Surgical Case Reports

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“…In younger patients, a predisposing cause is more easily recognized. Vasculitides, estrogens, cocaine and methamphetamine use, psychotropic drugs, sickle cell disease, long-distance running and heritable disorders of coagulation should be considered (32,33).…”

Section: Groups Chiu Scoresmentioning

confidence: 99%

Serum omentin levels predicts mesenteric ischemia

M¹,

Aktas²,

Ee³

et al. 2015

BLL

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Abstract:Background:Acute mesenteric ischemia (AMI) is an intestinal vascular disease with high mortality. Clinical diagnosis of acute mesenteric ischemia is diffi cult. Adipose tissue is an important mediator of metabolism and infl ammation.Omentin is produced by visceral adipose tissue and decreased serum levels of omentin are associated with poor metabolic outcomes. We aimed to investigate whether serum omentin level predicts early diagnosis of AMI before development of transmural ischemia. Methods: Twenty-four Sprague Dawley rats weighted about 200-250 gr grouped in 3 experimental groups as sham, transient ischemia and permanent ischemia. Each group consisted of 8 rats. Blood samples were evaluated to determine serum urea, creatinine, omentin and C-reactive protein (CRP) levels. A blinded histological examination performed with the same histologist for hemotoxileneosine painted ileal tissue samples. Results: Mean serum omentin level in sham group (27.5±4.67) was signifi cantly elevated compared to rats in Ischemia-reperfusion (IR) group (10.9±9.01).The difference reached the statistical signifi cance (p=0.004). Serum omentin levels were not correlated to urea, creatinine or CRPlevels. Conclusion:Omentin levels may be a biochemical indicator to detect AMI. However, further human studies are needed (Tab. 3, Fig. 3, Ref. 34). Text in PDF www.elis.sk.

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“…The endoscopic features areischemic enterocolitis and 'punched out' ulcers ( Figure 3). Although histopathological diagnosis of LMV can be obtained [19] , most endoscopic superficial biopsies might not yield a definitive diagnosis because the affected vessels are usually located in an inaccessible area [18] . The CT features include focal or diffuse bowel [11] with permission from Elsevier.…”

Section: Large-vessel Vasculitismentioning

confidence: 99%

Endoscopic and radiographic features of gastrointestinal involvement in vasculitis

Hokama

Kishimoto²,

Ihama³

et al. 2012

WJGE

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Vasculitis is an inflammation of vessel walls, followed by alteration of the blood flow and damage to the dependent organ. Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract. The variety of GI lesions includes ulcer, submucosal edema, hemorrhage, paralytic ileus, mesenteric ischemia, bowel obstruction, and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typical cases, including Churg-Strauss syndrome, HenochSchönlein purpura, systemic lupus erythematosus, and Behçet's disease. Important endoscopic features are ischemic enterocolitis and ulcer. Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign. Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy.

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Ischemic colitis associated with intestinal vasculitis: Histological proof in systemic lupus erythematosus

Cited by 24 publications

References 10 publications

A rare case of lupus-related gastrointestinal vasculitis presenting as rectal gangrene

A rare case of lupus-related gastrointestinal vasculitis presenting as rectal gangrene

Serum omentin levels predicts mesenteric ischemia

Endoscopic and radiographic features of gastrointestinal involvement in vasculitis

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