title: Inflammatory bowel disease and lupus: a systematic review of the literature.
abstract: Coexistence of systemic lupus erythematosus (SLE) should be considered in patients with inflammatory bowel disease (IBD) and complex extraintestinal manifestations and the diagnosis of IBD could be established either before or after the diagnosis of SLE. Differential diagnosis of concomitant SLE and IBD is difficult and should always exclude infectious conditions, lupus-like reactions, visceral vasculitis and drug-induced lupus. The underlying mechanism by which 5-ASA/sulphasalazine induces SLE or lupus-like syndromes is not clear and high awareness for possible predictive factors is demanded for early prevention. In most cases the symptoms from drug-induced lupus have been reversible after the discontinuation of the drug and response to steroids is favorable. Treatment of patients co-diagnosed with SLE and IBD may include corticosteroids, immunosupressants and hydroxychloroquine. In severe lupus and IBD patients cyclophosphamide pulse may be of benefit while infliximab may be beneficiary in patients with lupus nephritis. However, the role TNFalpha plays in humans with SLE and IBD is controversial and data on the likely effects of blocking TNFalpha on anti-DNA autoantibody production is always of interest.
authors.affiliation: 1st Division of Internal Medicine and Hepato-Gastroenterology Unit, Medical School, University of Ioannina, Ioannina 45110, Greece.
authors.forename: Konstantinos H
authors.initials: KH
authors.lastname: Katsanos
authors.forename: Paraskevi V
authors.initials: PV
authors.lastname: Voulgari
authors.forename: Epameinondas V
authors.initials: EV
authors.lastname: Tsianos
mesh_terms: D000068879:Adalimumab; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D000069285:Infliximab; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced / Q000150:complications* / Q000175:diagnosis; D019804:Mesalamine / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D019804:Mesalamine; D000069285:Infliximab; D000068879:Adalimumab