title: A patient with systemic lupus erythematosus who developed massive small intestinal hemorrhaging during treatment for chronic lupus peritonitis.
abstract: A 50-year-old Japanese woman, a patient with systemic lupus erythematosus (SLE) complicated with chronic lupus peritonitis, developed massive small intestinal hemorrhaging. She was treated with intravenous pulse of methylprednisolone, intravenous pulse of cyclophosphamide (IVCY), and immunoabsorption, but the peritonitis was refractory to these treatments. Subsequently, she was treated with oral corticosteroid and tacrolimus, and received IVCY monthly, but she developed massive small intestinal hemorrhaging 1 year after. Abdominal angiography detected multiple bleeding sites from the jejunal and ileal arteries. After transarterial embolization treatment, the melena disappeared. The pathology of this case appeared to be lupus mesenteric vasculitis.
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. shin-ya@hotmail.co.jp
authors.forename: Shin-ya
authors.initials: SY
authors.lastname: Kawashiri
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishino
authors.forename: Eijun
authors.initials: E
authors.lastname: Sueyoshi
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Koga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
mesh_terms: D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004621:Embolization, Therapeutic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007163:Immunosorbent Techniques; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007275:Injections, Intravenous; D007410:Intestinal Diseases / Q000150:complications* / Q000473:pathology / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D020551:Pulse Therapy, Drug; D017211:Treatment Failure; D016896:Treatment Outcome; D014657:Vasculitis / Q000150:complications / Q000473:pathology / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone