title: Clinical features and associated factors of abdominal pain in systemic lupus erythematosus.
abstract: OBJECTIVE
  To evaluate the clinical characteristics of systemic lupus erythematosus (SLE)-induced abdominal pain in a cohort in South China and identify the risk factors for SLE-induced abdominal pain.
  
  
  METHODS
  This is a retrospective cohort study of SLE patients with complaint of abdominal pain admitted to the first affiliated university hospital of Sun Yat-sen University between 2002 and 2011. Demographic information, clinical features, laboratory findings, SLE Disease Activity Index, and imaging characteristics were documented.
  
  
  RESULTS
  Of the 3823 SLE patients reviewed, 213 patients complained of abdominal pain and 132 cases were considered SLE-induced. The most common causes were lupus mesenteric vasculitis (LMV; 73.5%, 97/132) and lupus pancreatitis (LP; 17.4%, 23/132). Other causes included appendicitis, acute gastroenteritis, and peritonitis. Univariate and multivariate logistic regression analysis indicated the European Consensus Lupus Activity Measurement (ECLAM) score was significantly associated with lupus-induced abdominal pain (OR = 1.858, 95% CI: 1.441-2.394, p < 0.001), LMV (OR = 1.713, 95% CI: 1.308-2.244, p < 0.001), and LP (OR = 2.153, 95% CI: 1.282, 3.617, p = 0.004). The serum D-dimer level (OR = 1.004, 95% CI: 1.002-1.005, p < 0.001) was a strongly associated factor for lupus-induced abdominal pain. Moderate and large amounts of ascetic fluid was significantly associated with lupus-induced abdominal pain and LMV. Elevated liver enzymes was a risk factor for LP (OR = 34.605, 95% CI: 3.591-333.472, p = 0.002).
  
  
  CONCLUSIONS
  LMV and LP were the leading causes of SLE-induced abdominal pain. The serum D-dimer was a strongly associated factor for lupus-induced abdominal pain. ECLAM score was a reliable index in assessment of SLE-associated abdominal pain. Elevated liver enzymes, and moderate or large amounts of ascites, were positively associated with lupus-induced abdominal pain.
authors.affiliation: From the Department of Rheumatology and Clinical Immunology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Shiwen
authors.initials: S
authors.lastname: Yuan
authors.forename: Fan
authors.initials: F
authors.lastname: Lian
authors.forename: Dongying
authors.initials: D
authors.lastname: Chen
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.forename: Qian
authors.initials: Q
authors.lastname: Qiu
authors.forename: Zhongping
authors.initials: Z
authors.lastname: Zhan
authors.forename: Yujin
authors.initials: Y
authors.lastname: Ye
authors.forename: Hanshi
authors.initials: H
authors.lastname: Xu
authors.forename: Liuqin
authors.initials: L
authors.lastname: Liang
authors.forename: Xiuyan
authors.initials: X
authors.lastname: Yang
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology* / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D001201:Ascites / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013152:Splanchnic Circulation; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D014657:Vasculitis / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
keywords: ABDOMINAL PAIN; LOGISTIC REGRESSION; LUPUS MESENTERIC VASCULITIS; PANCREATITIS; SYSTEMIC LUPUS ERYTHEMATOSUS