A case of massive ascites due to lupus peritonitis with a dramatic response to steroid pulse therapy.

Ishiguro, Nozomi; Tomino, Yasuhiko; Fujito, Kazutaka; Nakayama, Shuei; Koide, Hikaru

doi:10.2169/internalmedicine1962.28.608

Cited by 14 publications

(11 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pleuritis and pericarditis have been recognized to be found frequently in elderly onset SLE compared with younger onset (3,4). However, chronic peritoneal serositis presenting painless ascites, so-called chronic lupus peritonitis, is especially rare and only 15 cases have been reported, as far as we know (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Here, we describe a case of chronic lupus peritonitis with massive painless ascites at elderly onset and review the literature to clarify the characteristics of this clinical entity.…”

Section: Introductionmentioning

confidence: 99%

Chronic Lupus Peritonitis with Massive Ascites at Elderly Onset: Case Report and Review of the Literature.

et al. 2002

View full text Add to dashboard Cite

A 77-year-old Japanese womanwith massive painless ascites caused by chronic lupus peritonitis is reported. Peritoneal effusion had been resistant to the administration of steroids during the whole treatment period. It was characteristic that the titers of anti-DNA antibodies and the level of immunecomplex were elevated in the peritoneal fluid with suppressed levels of complements in ascites, although serum immunological markers reflecting the activity of SLE presented improvement after initiation of the treatment. Fifteen patients with chronic lupus peritonitis were reported previously. Wereviewed the literature and suggest that chronic lupus peritonitis at elderly onset may demonstrate a poor response to the glucocorticoid therapy because of persistent inflammation in the peritoneum and the presence of impaired vascular circulation in addition to immunological mechanisms.

show abstract

Section: Introductionmentioning

confidence: 99%

Chronic Lupus Peritonitis with Massive Ascites at Elderly Onset: Case Report and Review of the Literature.

et al. 2002

View full text Add to dashboard Cite

show abstract

“…According to the literature, non-steroidal anti-inflammatory drugs (NSAIDs) 13 , antimala-rials 3,14 and immunosuppressive drugs including glucocorticoids 3,[15][16][17] , azathioprine 15,18 and cyclophosphamide 19 have been used in the management of LP-associated ascites. Patients usually respond well to steroids 16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Patients usually respond well to steroids 16,17 . Antimalarial agents are generally used as an adjunct to other treatments for SLE, such as NSAIDs and glucocorticoids 20 .…”

Section: Discussionmentioning

confidence: 99%

Massive and painful ascites as a presenting manifestation of systemic lupus erythematosus flare: a case report and literature review

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Ascites usually responds promptly to steroids. 4 However, prior to their administration, other potential causes, especially infection and malignancy, should be excluded.…”

Section: Discussionmentioning

confidence: 99%

“…4 Here we report a patient who presented for the first time with massive ascites and pancreatitis due to SLE.…”

mentioning

confidence: 92%

Systemic Lupus Erythematosus Presenting as Massive Ascites and Pancreatitis

et al. 1996

View full text Add to dashboard Cite

MA Mohammed Nur, QQ Contractor, AE Ibrahim, EM Hassan, Systemic Lupus Erythematosus Presenting asMassive Ascites and Pancreatitis. 1996; 16(1): 77-78 Systemic lupus erythematosus (SLE) can present rarely with gastrointestinal tract manifestations such as intestinal obstruction, perforation, protein-losing enteropathy, portal hypertension, Budd-Chiari syndrome, serositis and ascites.1 There are 12 reported cases of SLE with acute pancreatitis in patients who were not on any medications. 2Peritoneal involvement has been found in two-thirds of patients with SLE who undergo necropsy, though it is detected clinically in only 4% to 16%.3 Ascites may present acutely or chronically and massive ascites with SLE is extremely rare. 4Here we report a patient who presented for the first time with massive ascites and pancreatitis due to SLE. Case ReportA 40-year-old Saudi female presented for the first time with a six-week history of anorexia, abdominal pain and distention. She had had polyarthralgia for the previous four years and a single episode of skin rash on the bridge of her nose. The heart was normal and chest examination revealed left pleural effusion. The abdomen was markedly distended with full flanks, everted umbilicus and a fluid thrill which suggested the presence of massive ascites. There was no organomegaly. One week after admission, the patient developed a painful ulcer on the lower lip, measuring 1 cm x 2.5 cm.Laboratory evaluation showed a hemoglobin of 10.5 g/dL, leukocyte count 3.9x10 and ESR 107 mm/lst hour. Serum amylase was 1200 IU (N=0 to 220 IU), liver function tests were unaltered, 24-hour urinary protein was 580 mg and creatinine clearance 75.3 mL/min. Plasma ANF and anti-DNA were positive. HBsAg and anti-HCV were negative. Ascitic fluid amylase was 1890 IU, protein 4.29 g/dL, cell count 50/mm 3 with 97% monocytes; ANF and anti-DNA were positive and culture was sterile. Pleural fluid was also an exudate with positive ANF and anti-DNA. Abdominal ultrasound revealed massive ascites and hypoechoic pancreas while computed tomography (CT) of the abdomen showed ascites and enlarged hypodense pancreas, findings consistent with pancreatitis and ascites.The above investigations suggested a diagnosis of SLE. Prednisolone 1 mg/kg body weight and diuretics were started. As the response was very sluggish over two weeks, azathioprine 2.5 mg/kg was added, with prompt resolution of the ascites. DiscussionAcute pancreatitis with pancreatitis ascites in our patient is suggested by high serum and ascitic fluid amylase as well as findings of abdominal ultrasonography and CT scan. The patient also fulfills the revised American College of Rheumatology criteria for SLE.

show abstract

A case of massive ascites due to lupus peritonitis with a dramatic response to steroid pulse therapy.

Cited by 14 publications

References 2 publications

Chronic Lupus Peritonitis with Massive Ascites at Elderly Onset: Case Report and Review of the Literature.

Chronic Lupus Peritonitis with Massive Ascites at Elderly Onset: Case Report and Review of the Literature.

Massive and painful ascites as a presenting manifestation of systemic lupus erythematosus flare: a case report and literature review

Systemic Lupus Erythematosus Presenting as Massive Ascites and Pancreatitis

Contact Info

Product

Resources

About