A patient with systemic lupus erythematosus who developed massive small intestinal hemorrhaging during treatment for chronic lupus peritonitis

Kawashiri, Shin‐ya; Nishino, Ayako; Sueyoshi, Eijun; Okada, Akitomo; Koga, Tomohiro; Yamasaki, Satoshi; Nakamura, Hideki; Origuchi, Tomoki; Kawakami, Atsushi

doi:10.1007/s10165-011-0499-3

Cited by 2 publications

(2 citation statements)

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“… 14 The mechanism of ANCA-negative vasculitis is unclear but it could involve immune complex deposition and microvascular thrombosis associated with anti-phospholipid antibodies which would then exacerbate mucosal damage and lead to extensive gastrointestinal bleeding. 6 , 15 The fact that our patient responded well to immunosuppressive therapies supports this theory.…”

Section: Discussionsupporting

confidence: 66%

“… 2 , 3 The complications of SLE are protean and severe and may include lupus pneumonitis, lupus encephalopathy, intestinal pseudo-obstruction, gastrointestinal bleeding and vasculitis. 4 – 7 It is important for clinicians to recognize SLE and its complications early on in its course and treat the disease promptly and intensively. 8 We report here on a rare case of multisystem damage in a 29-year-old Chinese woman with SLE.…”

Section: Introductionmentioning

confidence: 99%

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Acute diffuse alveolar haemorrhage accompanied by gastrointestinal bleeding in a patient with serious systemic lupus erythematosus: A case report

Wang

et al. 2018

J Int Med Res

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Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding. Although intensive treatment was administered, the patient deteriorated rapidly and had a progressive decline in oxygen saturation followed by diffuse alveolar haemorrhage and acute left heart failure. Inotropic therapy, mechanical ventilation, blood transfusion, CRRT, antibiotics, intravenous glucocorticoids and other support therapies were initiated and gradually the patient’s vital signs stabilized and haemoptysis subsided. This case report emphasises that complications of SLE can occur at any stage of the disease, especially in patients with active SLE. Therefore, it is important for clinicians to be aware of the rare presentations of SLE and its complex management. For multisystem dysfunction, early intensive treatment with high dose corticosteroids and cyclophosphamide is advocated.

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Section: Discussionsupporting

confidence: 66%