title: [Longstanding intractable massive ascites caused by chronic lupus peritonitis with nephrotic syndrome: a case report].
abstract: A 36-year-old woman with systemic lupus erythematosus (SLE) and nephrotic syndrome showed massive ascites. She was admitted to our hospital because of edema in both legs and a remarkably distended non-tender abdomen. On admission, massive ascites was observed in the abdominal CT scan findings. Laboratory examination of the ascites showed low levels of total protein (1.5 g/dL), albumin (0.5 g/dL) and LDH (89 IU/L), which were characterized as ascites per diapedesis. In addition, she was diagnosed with SLE and nephrotic syndrome from the clinical and laboratory findings. We treated her with steroid therapy, including methylprednisolone plus therapy. Although the serological abnormalities with SLE had normalized and urinary protein almost disappeared on the 51th hospital day, the ascites had not improved at all. These findings indicated that she had suffered from chronic lupus peritonitis, complicated with nephrotic syndrome and we had continued to treat her with prednisolone for a long time. The ascites was remarkably diminished at 220 days after admission. We believe that in addition to nephrotic syndrome, impaired vascular circulation caused by chronic lupus peritonitis might have contributed to accumulation of the massive ascites.
authors.affiliation: Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Fuke
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ikeda
authors.forename: Chie
authors.initials: C
authors.lastname: Shimizu
authors.forename: Mamiko
authors.initials: M
authors.lastname: Kajiwara
authors.forename: Ken
authors.initials: K
authors.lastname: Ito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Satomura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D001201:Ascites / Q000188:drug therapy / Q000209:etiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008181:Lupus Nephritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D008775:Methylprednisolone / Q000008:administration & dosage; D009404:Nephrotic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010538:Peritonitis / Q000150:complications* / Q000188:drug therapy; D020551:Pulse Therapy, Drug; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008775:Methylprednisolone