Pancreatitis as initial manifestation of systemic lupus erythematosus

Essaadouni, L.; Samar, E; Krati, K.

doi:10.1177/0961203309356456

Cited by 15 publications

(31 citation statements)

References 12 publications

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“…The cause of SLE‐pancreatitis has been attributed to a variety of mechanisms, including vasculitis, microthrombi formation related to antiphospholipid antibody, anti‐pancreatic antibodies and pancreatic inflammation due to T‐cell infiltration and complement activation 12 . However, microthrombi as the cause of pancreatitis was unlikely in the present patient because the tests for anti‐phospholipid antibodies were negative.…”

Section: Discussionmentioning

confidence: 67%

“…In an SLE patient who is unresponsive to the standard line of drug treatment, including adequate doses of glucocorticoids, then high‐dose intravenous immunoglobulin or cytotoxic agents like cyclophosphamide are recommended 12,29 . The patient presented in this report was treated accordingly (high dose i.v.‐cyclophosphamide) with excellent response.…”

Section: Discussionmentioning

confidence: 95%

“…In the context of drug‐induced pancreatitis it is important to discuss the suspected role of glucocorticoids, especially since the patient presented here did receive a large dose of methylprednisolone intravenously just prior to the onset of the problem. Because of the widely held belief in its etiological role, most physicians would incriminate glucocorticoid in the aetiology of pancreatitis 12,30–32 . Older studies have suggested steroid‐associated pancreatitis, but several later studies have doubted this association 30–32 .…”

Section: Discussionmentioning

confidence: 99%

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Acute abdomen in SLE

et al. 2010

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Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune connective tissue disease with protean manifestations. Most often it presents with mucocutaneous, musculoskeletal or renal involvement. In comparison, gastrointestinal (GI) manifestations of SLE are far less common. The case presented here highlights the differential diagnosis of GI manifestations of SLE that range from non-life-threatening to serious life-threatening complications, including some of the complications of on-going drug treatments. While some of them present as 'acute abdomen', others are more subacute or chronic, yet serious enough to be life-threatening. The serious GI manifestations of SLE include mesenteric vasculitis causing perforation or hemorrhage with peritonitis, acute pancreatitis and intestinal pseudo-obstruction. The patient in this paper had clinical features, imaging findings and laboratory parameters that helped the treating physician to narrow down the diagnostic possibilities and finally, in making the diagnosis of lupus-pancreatitis. She was treated with intravenous 'bolus' (i.v.-pulse) methylprednisolone for 3 days, i.v.-pulse cyclophosphamide 750 mg (one dose) along with oral methylprednisolone and other supportive measures including blood transfusions. This led to prompt and complete recovery.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Acute abdomen in SLE

et al. 2010

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“…Gastrointestinal (GI) manifestations are common in SLE patients, but acute pancreatitis is rare [1–6]. It was reported that 19.2%–50% of SLE patients presented with gastrointestinal symptoms [7–11], whereas pancreatitis occurred in about 0.7%–8.2% of patients with SLE [7, 8, 11, 12] and the annual incidence was approximately 0.4–1.1‰ [3–5].…”

Section: Introductionmentioning

confidence: 99%

Systemic-Lupus-Erythematosus-Related Acute Pancreatitis: A Cohort from South China

Yang¹,

Ye²,

Liu³

et al. 2012

Clinical and Developmental Immunology

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Acute pancreatitis (AP) is a rare but life-threatening complication of SLE. The current study evaluated the clinical characteristics and risk factors for the mortality of patients with SLE-related AP in a cohort of South China. Methods. Inpatient medical records of SLE-related AP were retrospectively reviewed. Results. 27 out of 4053 SLE patients were diagnosed as SLE-related AP, with an overall prevalence of 0.67%, annual incidence of 0.56‰ and mortality of 37.04%. SLE patients with AP presented with higher SLEDAI score (21.70 ± 10.32 versus 16.17 ± 7.51, P = 0.03), more organ systems involvement (5.70 ± 1.56 versus 3.96 ± 1.15, P = 0.001), and higher mortality (37.04% versus 0, P = 0.001), compared to patients without AP. Severe AP (SAP) patients had a significant higher mortality rate compared to mild AP (MAP) (75% versus 21.05%, P = 0.014). 16 SLE-related AP patients received intensive GC treatment, 75% of them exhibited favorable prognosis. Conclusion. SLE-related AP is rare but concomitant with high mortality in South Chinese people, especially in those SAP patients. Activity of SLE, multiple-organ systems involvement may attribute to the severity and mortality of AP. Appropriate glucocorticosteroid (GC) treatment leads to better prognosis in majority of SLE patients with AP.

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“…[469][470][471][472][473][474] Lupus mesenteric vasculitis (LMV), a leukocytoclastic vasculitis of mesenteric vessel walls, also known as lupus enteritis, usually presents with abdominal pain, sometimes associated with impaired intestinal motility and signs of peritonitis. The most frequent symptoms in both adults in children are abdominal pain, nausea, vomiting, and fever.…”

Section: Cytopenia Type Frequency Key Laboratory Features Managementmentioning

confidence: 99%