Systemic lupus erythematosus and intestinal venulitis.
A 22-yr-old woman with a 7-yr history of systemic lupus erythematosus presented with anasarca and a serum albumin of 0.8 g/dl. Renal and hepatic function were near normal; the major route of protein loss appeared to be the intestine. A full-thickness section of jejunum obtained at laparotomy demonstrated a severe, diffuse vasculitis involving the venules of the submucosa and muscularis externa with infiltration of polymorphonuclear leukocytes and macrophages, and deposits of C3. There was a similar focal damage of the walls of the small vessels in the lamina propria, and deposits of C3 and fibrinogen in a thickened basement membrane of the intestinal villi. This report documents that in systemic lupus erythematosus the intestine can be affected with a vasculitis similar to that seen in the skin and can cause thickening of the basement membrane of intestinal villi. These lesions may be responsible for protein-losing enteropathy.
D000293:Adolescent; D000328:Adult; D004487:Edema / Q000150:complications; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications / Q000473:pathology; D007583:Jejunum / Q000098:blood supply* / Q000648:ultrastructure; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008854:Microscopy, Electron; D014657:Vasculitis / Q000150:complications*