title: Abdominal pain as the initial and sole clinical presenting feature of systemic lupus erythematosus.
abstract: Classically, a diagnosis of systemic lupus erythematosus (SLE) is dependent on renal, rheumatological, cutaneous and neurological target organ damage with supporting serological markers. A previously healthy 26-year-old Japanese woman whose only manifestation of otherwise occult SLE was severe abdominal pain is reported. A computed tomographic scan of the abdomen revealed thickened loops of small bowel, endoscopic findings were nonspecific and jejunal biopsy revealed a nonspecific enteritis. Laboratory studies revealed lymphopenia, hypocomplementemia, a positive antinuclear antibody, a weakly positive anti-Smith and a strongly positive anti-double stranded DNA. There was a prompt symptomatic recovery with immunosuppressive therapy. The authors' experiences, and a review of the literature suggest that a diagnosis of SLE should be considered in young Asian women who present with significant but clinically enigmatic gastrointestinal illness.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: Henry V
authors.initials: HV
authors.lastname: Chung
authors.forename: Alnoor
authors.initials: A
authors.lastname: Ramji
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Davis
authors.forename: Sylvia
authors.initials: S
authors.lastname: Chang
authors.forename: Graham D
authors.initials: GD
authors.lastname: Reid
authors.forename: Baljinder
authors.initials: B
authors.lastname: Salh
authors.forename: Hugh J
authors.initials: HJ
authors.lastname: Freeman
authors.forename: Eric M
authors.initials: EM
authors.lastname: Yoshida
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D004386:Duodenum / Q000473:pathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology