Polyserositis and Acute Acalculous Cholecystitis: An Uncommon Manifestation of Undiagnosed Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) is a common systemic disease in the rheumatologic field. Serositis and gastrointestinal symptoms are common manifestations of SLE; however, polyserositis concurrently with acute acalculous cholecystitis is a rare and usually underestimated entity that can be associated with SLE. Medical treatment with steroids is efficacious and, in most instances, cholecystectomy can be avoided. We present the case of a young female patient with polyserositis and acute acalculous cholecystitis secondary to undiagnosed SLE, who eventually required surgical laparoscopic intervention and improved with immunosuppressive treatment.

All that Glitters is not Cholecystitis. A Rare Presentation of Acute Pericarditis Mimicking Cholecystitis and Review of the Literature

“…The simultaneous existence of acalculous cholecystitis and pericardial effusion or pericarditis can reveal underlying diseases, causing these lesions (Table 2). These underlying diseases include rheumatological disorders such as lupus erythematosus or Churg-Strauss syndrome [18][19][20]. In addition, bacterial or parasitic infections, such as Leptospira or Ascaris, are reported in the literature [21,22].…”

Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?

“…After identifying 671 articles, 153 articles involving 171 cases were eligible: 104 viral infection and 67 rheumatic disease AAC patients. [8,11–162] Viral infection types included: Epstein Barr virus, hepatitis virus, dengue virus, SARS-CoV-2 (COVID-19), human immunodeficiency virus, and cytomegalovirus. Rheumatic diseases included: systemic lupus erythematosus, adult-onset Still disease, Henoch-Schönlein purpura, polyarteritis nodosa, Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis), microscopic polyangiitis, temporal arteritis, Wegener granulomatosis (granulomatosis with polyangiitis), Kawasaki syndrome, systemic juvenile idiopathic arthritis, and juvenile dermatomyositis (Table 1).…”