Lupus Hepatitis, a diagnostic challenge

Abstract

A 25-year-old woman with a recent diagnosis of systemic lupus erythematosus and grade II lupus nephritis presented with a 14day evolution condition characterized by severe, colicky type, abdominal pain with a predominance on upper hemiabdomen, without irradiation, with partial response to non-steroid anti-inflammatory drugs, associated with nausea and two episodes of self-limiting diarrhea (hypocholia). She also referred polyarthralgia predominantly in the hands, wrists, shoulders, and knees, disabling for daily activities, associated with weight loss of 10 kilos, photosensitivity and alopecia. Physical examination revealed normotension, heart rate 90 bpm, afebrile, no lymph nodes, alopecia, malar rash, no presence of mucosal ulcers or synovitis; generalized mucosal cutaneous jaundice. The abdomen was soft, depressible and painless, with positive airfluid sounds without visceromegaly.