Indications for colonoscopy in patients with systemic lupus erythematosus.
OBJECTIVE
Systemic lupus erythematosus is a systemic autoimmune disorder that sometimes involves the gastrointestinal tract. The aim of this study is to describe the clinical characteristics of patients with systemic lupus erythematosus with colorectal involvement, and to provide criteria for colonoscopy.


METHODS
Among 288 patients with systemic lupus erythematosus, 29 patients underwent colonoscopy. The clinical backgrounds were comparatively analyzed between the patients with colorectal involvements (n = 11, group A) and the patients without colorectal involvements (n = 18, group B). Endoscopic features were also evaluated in group A patients.


RESULTS
The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) of the group A patients was higher than that of the group B patients. Abdominal pain (n = 6) and diarrhea (n = 5) were significantly correlated with the presence of colorectal involvements, and other manifestations in group A patients included visible blood in stools (n = 5) and fever (n = 1). In colonoscopy, discrete ulcers (n = 5), longitudinal ulcers (n = 1), erosions and/or small ulcers (n = 2), edematous mucosa (n = 2), and concurrent ulcerative colitis (n = 1) were identified.


CONCLUSIONS
Patients with systemic lupus erythematosus with SLEDAI scores > or = 5, or with gastrointestinal symptoms, particularly those who present with abdominal pain or diarrhea should undergo colonoscopy, because these patients are likely to have mucosal damage in the colorectum.
Masaya
M
Iwamuro
Hiroyuki
H
Okada
Jun
J
Kato
Takehiro
T
Tanaka
Ken-Ei
KE
Sada
Hirofumi
H
Makino
Kazuhide
K
Yamamoto
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult