title: Intestinal pseudo-obstruction in inactive systemic lupus erythematosus: An unusual finding.
abstract: Chronic intestinal pseudo-obstruction (CIP) is an infrequent complication of an active systemic lupus erythematosus (SLE). We illustrate a case of SLE inactive-related CIP. A 51-year old female with inactive SLE (ECLAM score 2) was hospitalized with postprandial fullness, vomiting, abdominal bloating and abdominal pain. She had had no bowel movements for five days. Plain abdominal X-ray revealed multiple fluid levels and dilated small and large bowel loops with air-fluid levels. Intestinal contrast radiology detected dilated loops. CIP was diagnosed. The patient was treated with prokinetics, octreotide, claritromycin, rifaximin, azathioprine and tegaserod without any clinical improvement. Then methylprednisolone (500 mg iv daily) was started. After the first administration, the patient showed peristaltic movements. A bowel movement was reported after the second administration. A plain abdominal X-ray revealed no air-fluid levels. Steroid therapy was slowly reduced with complete resolution of the symptoms. The patient is still in a good clinical condition. SLE-related CIP is generally reported as a complication of an active disease. In our case, CIP was the only clinical demonstration of the SLE.
authors.affiliation: Giulia Leonardi, Nicola de Bortoli, Massimo Bellini, Maria Gloria Mumolo, Francesco Costa, Angelo Ricchiuti, Santino Marchi, Gastroenterology Unit, Cisanello Hospital, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Leonardi
authors.forename: Nicola
authors.initials: N
authors.lastname: de Bortoli
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellini
authors.forename: Maria Gloria
authors.initials: MG
authors.lastname: Mumolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Costa
authors.forename: Angelo
authors.initials: A
authors.lastname: Ricchiuti
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.forename: Santino
authors.initials: S
authors.lastname: Marchi