Pancreatitis in Systemic Lupus Erythematosus: Frequency and Associated Factors — A Review of the Hopkins Lupus Cohort

Abstract

Hypertriglyceridemia appears to be a strong associate of pancreatitis in SLE, but antiphospholipid antibodies are not. SLE patients with psychosis and pleurisy are at increased risk for pancreatitis.

A case of SLE with pancreatitis

“…9 In Hopkins cohort, appropriate treatment with corticosteroids added a survival benefit in SLE -related acute pancreatitis. 5 Our patient did not receive glucocorticoids. There is still a controversy over steroid treatment in SLE-related acute pancreatitis.…”

“…4 The Hopkins lupus cohort reported the largest case series with 63 SLE attribute pancreatitis out of 1740 SLE patients (3.5%), and a Taiwan series reported 40 out of 2976 SLE patients (1.34%). 5,6 In a study conducted by yanlong yang, yujin ye, liuquin liang, et al, 27 out of 4053 SLE patients were diagnosed as SLE-related Acute pancreatitis, with an overall prevalence of 0.67%, annual incidence of 0.56% and mortality of 37.04%. SLE patients with acute pancreatitis presented with higher SLE Disease activity index score SLEDAI (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 acute pancreatitis.…”

Silence pancreatitis in systemic lupus erythematosus

“…In SLE-related pancreatitis, approximately 90% have abdominal pain, almost 75% of patients have nausea and vomiting, and about 50% have fever (2,4,6).…”

“…In SLE related pancreatitis, increased values for serum amylase and lipase are the most commonly detected (2,6). Normal serum amylase levels have been reported in some cases of acute pancreatitis, but serum lipase levels are usually elevated.…”

“…The high mortality rate in SLE pancreatitis is associated with severe disease activity, thrombocytopenia and acute renal failure (3,4,6). Due to clinically significant renal failure, our patient was referred to haemodialysis treatment via CVK.…”