Fatal acute pancreatitis complicated by pancreatic pseudocysts in a patient with systemic lupus erythematosus.
Pancreatitis is a relatively rare but severe manifestation in systemic lupus erythematosus (SLE) patients. We report a case of a 39-year-old woman with previous SLE diagnose treated with prednisone and mycophenolate mofetil who developed an acute pancreatitis complicated by pancreatic pseudocysts within the context of a severe lupus flare. Elevated serum amylase and computerized tomography confirmed the diagnosis and mechanical obstruction or toxic-metabolic etiologies were ruled out. In the present case, we opted for the clinical surveillance of pancreatic pseudocyst and not perform invasive medical procedures to drainage. A steroid therapy was started in order to achieve SLE and pancreatitis remission, however, it was unable to avoid the development of multiorgan failure and patient died a few days after diagnosis was made.
Cairoli
Ernesto
E
Unidad de Enfermedades Autoinmunes Sistémicas, Facultad de Medicina, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay. ecairoli@hc.edu.uy
Pérez
Gerardo
G
Briva
Arturo
A
Cancela
Mario
M
Alonso
Juan
J
D000208:Acute Disease; D000328:Adult; D000681:Amylases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D009102:Multiple Organ Failure / Q000209:etiology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000209:etiology*; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D000681:Amylases; D009173:Mycophenolic Acid; D011241:Prednisone