title: Acute acalculous cholecystitis induced by mesenteric inflammatory veno-occlusive disease (MIVOD) in systemic lupus erythematosus.
abstract: 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.
authors.affiliation: School of Medicine, Juntendo University, 2-1-1 Hongo Bunkyo-Ku, 113-8421 Tokyo, Japan. shigeto@med.juntendo.ac.jp
authors.forename: Hideaki
authors.initials: H
authors.lastname: Bando
authors.forename: Shigeto
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Naoto
authors.initials: N
authors.lastname: Tamura
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yamaji
authors.forename: Chiho
authors.initials: C
authors.lastname: Takasaki
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Takasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hashimoto
mesh_terms: 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