title: Mycophenolate mofetil inducing remission of lupus enteritis.
abstract: We report the case of a young woman with a background history of discoid lupus who presented with abdominal pain, vomiting and intermittent diarrhoea. Physical examination revealed tenderness in the right upper quadrant with a palpable right inguinal lymph node without any other clinical signs of active lupus. Laboratory investigations showed normal inflammatory markers, positive ANA and Anti-Ro antibodies, persistent hypocomplementemia and lymphopenia, CT showed marked bowel oedema involving the small and large bowel (halo sign) with massive ascites and moderate right-sided pleural effusion. Mantoux test, AFB and TB cultures were negative. A diagnosis of lupus enteritis was made and treatment with high-dose steroids was commenced with little improvement. Treatment with cyclophosphamide was discussed but declined by the patient. Mycophenolate mofetil was commenced and resulted in significant clinical and radiological resolution. To the best of the authors' knowledge this is the first report of the successful use of mycophenolate mofetil in inducing and maintaining remission in lupus enteritis.
authors.affiliation: Rheumatology Department, Bart's and The London NHS trust London, UK. dr.farida.balushi@gmail.com
authors.forename: F
authors.initials: F
authors.lastname: Al Balushi
authors.forename: F
authors.initials: F
authors.lastname: Humby
authors.forename: A
authors.initials: A
authors.lastname: Mahto
authors.forename: C
authors.initials: C
authors.lastname: Kelly
authors.forename: A
authors.initials: A
authors.lastname: Jawad
mesh_terms: D000328:Adult; D004751:Enteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008179:Lupus Erythematosus, Discoid / Q000150:complications* / Q000188:drug therapy; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012074:Remission Induction / Q000379:methods; D012261:Ribonucleoproteins / Q000276:immunology; D016896:Treatment Outcome; D000099207:SS-A Antigen
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D012261:Ribonucleoproteins; D000099207:SS-A Antigen