title: Fulminant amoebic colitis mimicking intestinal vasculitis in a patient with systemic lupus erythematosus.
abstract: Colitis in patients with systemic lupus erythematosus (SLE) is quite rare. It can be caused by intestinal vasculitis, mesenteric vascular thrombosis, concomitant inflammatory bowel disease or infectious colitis. It is important to make an accurate and early diagnosis as the treatments for each condition differ and a delayed diagnosis can result in life-threatening complications. However, non-specific gastrointestinal symptoms make a timely diagnosis challenging. Amoebic colitis is a rare condition in patients with SLE. Here we present a case of fulminant amoebic colitis in a patient with SLE which was initially misdiagnosed as ischemic colitis due to intestinal vasculitis. Her colitis was complicated with multiple intestinal perforations, disseminated intravascular coagulation and acute respiratory distress syndrome; but in the end, the patient was successfully treated with metronidazole and paromomycin.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, South Korea.
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.forename: H-S
authors.initials: HS
authors.lastname: Jung
authors.forename: H-C
authors.initials: HC
authors.lastname: Nam
authors.forename: S-K
authors.initials: SK
authors.lastname: Kwok
authors.forename: J H
authors.initials: JH
authors.lastname: Ju
authors.forename: K-S
authors.initials: KS
authors.lastname: Park
authors.forename: H-Y
authors.initials: HY
authors.lastname: Kim
authors.forename: S-H
authors.initials: SH
authors.lastname: Park
mesh_terms: D000981:Antiprotozoal Agents / Q000627:therapeutic use; D017091:Colitis, Ischemic / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004404:Dysentery, Amebic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000469:parasitology*; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010303:Paromomycin / Q000627:therapeutic use; D014657:Vasculitis / Q000175:diagnosis*
chemical_list: D000981:Antiprotozoal Agents; D008795:Metronidazole; D010303:Paromomycin