Abdominal pain as the initial and sole clinical presenting feature of systemic lupus erythematosus.
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.
Chung
Henry V
HV
Department of Medicine, University of British Columbia, Vancouver, Canada.
Ramji
Alnoor
A
Davis
Jennifer E
JE
Chang
Sylvia
S
Reid
Graham D
GD
Salh
Baljinder
B
Freeman
Hugh J
HJ
Yoshida
Eric M
EM
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