Acute acalculous cholecystitis induced by mesenteric inflammatory veno-occlusive disease (MIVOD) in systemic lupus erythematosus.
A 43-year-old woman with systemic lupus erythematosus (SLE) was treated for lupus pleurisy. During the course of her illness, she abruptly suffered severe right hypochondriac pain and high-grade fever. Abdominal ultrasonography revealed a thickening of the gallbladder wall without cholelithiasis, and she was diagnosed with acute acalculous cholecystitis (AAC). Laparoscopic cholecystostomy was performed. Pathological examination revealed lymphocytic venulitis without arteritis. Antiphospholipid antibodies were not demonstrated during the course of illness. From these findings, the cause of AAC was revealed as a mesenteric inflammatory veno-occlusive disease (MIVOD), which is a novel venopathy mainly affecting the mesenteric vein and/or its branches, causing serious ischemic complications. MIVOD should be considered as a possible cause of AAC.
Bando
Hideaki
H
School of Medicine, Juntendo University, 2-1-1 Hongo Bunkyo-Ku, 113-8421 Tokyo, Japan. shigeto@med.juntendo.ac.jp
Kobayashi
Shigeto
S
Matsumoto
Toshiharu
T
Tamura
Naoto
N
Yamanaka
Kenjiro
K
Yamaji
Chiharu
C
Takasaki
Chiho
C
Takasaki
Yoshinari
Y
Hashimoto
Hiroshi
H
D042101:Acalculous Cholecystitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D001707:Biopsy, Needle; D002758:Cholangiography; D002763:Cholecystectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008642:Mesenteric Veins; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome