title: Chronic lupus peritonitis with massive ascites at elderly onset: case report and review of the literature.
abstract: A 77-year-old Japanese woman with massive painless ascites caused by chronic lupus peritonitis is reported. Peritoneal effusion had been resistant to the administration of steroids during the whole treatment period. It was characteristic that the titers of anti-DNA antibodies and the level of immune complex were elevated in the peritoneal fluid with suppressed levels of complements in ascites, although serum immunological markers reflecting the activity of SLE presented improvement after initiation of the treatment. Fifteen patients with chronic lupus peritonitis were reported previously. We reviewed the literature and suggest that chronic lupus peritonitis at elderly onset may demonstrate a poor response to the glucocorticoid therapy because of persistent inflammation in the peritoneum and the presence of impaired vascular circulation in addition to immunological mechanisms.
authors.affiliation: Second Department of Internal Medicine, Kochi Medical School, Nankoku.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Wakako
authors.initials: W
authors.lastname: Nanamiya
authors.forename: Naoto
authors.initials: N
authors.lastname: Kuroda
authors.forename: Mari
authors.initials: M
authors.lastname: Inoue
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasaoka
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Chijiwa
authors.forename: Koji
authors.initials: K
authors.lastname: Nishiya
authors.forename: Kozo
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakagawa
mesh_terms: D000367:Age Factors; D000368:Aged; D001201:Ascites / Q000150:complications*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D010538:Peritonitis / Q000150:complications*