Chronic Diarrhea as the Presenting Complaint of Systemic Lupus Erythematosus in a Man

Rajendiran, Ashwin; Viswanathan, Stalin; Remalayam, Bhavith; Muthu, Vivekanandan

doi:10.2169/internalmedicine.51.8518

Cited by 8 publications

(2 citation statements)

References 11 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For SLE-associated PLE, this systematic review identified 200 cases, reported from 66 case report studies, 6–71 3 case control studies 72–74 and 2 case series studies. 75,76…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal system involvement in systemic lupus erythematosus

Wang

et al. 2017

Lupus

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is a multisystem disorder which can affect the gastrointestinal (GI) system. Although GI symptoms can manifest in 50% of patients with SLE, these have barely been reviewed due to difficulty in identifying different causes. This study aims to clarify clinical characteristics, diagnosis and treatment of the four major SLE-related GI system complications: protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), hepatic involvement and pancreatitis. It is a systematic review using MEDLINE and EMBASE databases and the major search terms were SLE, PLE, IPO, hepatitis and pancreatitis. A total of 125 articles were chosen for our study. SLE-related PLE was characterized by edema and hypoalbuminemia, with Technetium 99m labeled human albumin scintigraphy (Tc HAS) and alpha-1-antitrypsin fecal clearance test commonly used as diagnostic test. The most common site of protein leakage was the small intestine and the least common site was the stomach. More than half of SLE-related IPO patients had ureterohydronephrosis, and sometimes they manifested as interstitial cystitis and hepatobiliary dilatation. Lupus hepatitis and SLE accompanied by autoimmune hepatitis (SLE-AIH overlap) shared similar clinical manifestations but had different autoantibodies and histopathological features, and positive anti-ribosome P antibody highly indicated the diagnosis of lupus hepatitis. Lupus pancreatitis was usually accompanied by high SLE activity with a relatively high mortality rate. Early diagnosis and timely intervention were crucial, and administration of corticosteroids and immunosuppressants was effective for most of the patients.

show abstract

“…For SLE-associated PLE, this systematic review identified 200 cases, reported from 66 case report studies, 6–71 3 case control studies 72–74 and 2 case series studies. 75,76…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal system involvement in systemic lupus erythematosus

Wang

et al. 2017

Lupus

View full text Add to dashboard Cite

show abstract

“…Our clinical observations indicated that patients with SLE-related PLE had worse outcomes than patients without. However, the current data that describe SLE-related PLE are limited to case reports [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ] or case series that comprise a limited number of patients, [ 11 , 12 , 13 ] and most of these reports described the patients’ clinical characteristics and short-term responses to different immunosuppressants. [ 14 , 15 , 16 , 17 ] To date, the long-term outcomes of patients with SLE-related PLE have not been described.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and long-term outcomes of patients with lupus-related protein-losing enteropathy: A retrospective study

Peng

et al. 2020

Rheumatology and Immunology Research

View full text Add to dashboard Cite

ObjectivesThe long-term outcomes of patients with systemic lupus erythematosus (SLE)-related protein-losing enter-opathy (PLE) are unclear. This study was aimed to investigate the clinical characteristics and long-term outcomes of patients with SLE-related PLE.MethodsThis retrospective cohort study enrolled 58 patients with SLE-related PLE who were admitted to our center from January 2000 to June 2016. The patients’ baseline characteristics and follow-up data were analyzed, and the prognostic outcomes were survival and disease flares. The prognoses were analyzed using Kaplan-Meier curves, log-rank tests, and Cox regression models. Factors with values of P<0.05 were considered potential predictors.ResultsTwo-thirds of patients had intestinal symptoms, and 77.6% of patients had concomitant organ/system involvement, including serositis (77.6%), lupus nephritis (57.6%), neuropsychiatric lupus (10.3%), and hematological disorders (22.4%). Common abnormalities in the laboratory test results were hypocomplementemia (87.9%), anti-Sjögren syndrome antigen A antibodies (51.7%), and high total cholesterol levels (62.1%). Five flares were recorded in 47 patients. The 1-, 3-, and 5-year survival rates were 93.6%, 91.3%, and 88.4%, respectively. Infection was the cause of death in 60% of patients. High 24-hour urine protein level was an independent risk factor associated with death (P = 0.012). Severe hypoalbuminemia (<12 g/L) was a predictor of disease flares in SLE-related PLE (hazard ratio, 10.345; 95% confidence interval, 1.690–63.321).ConclusionsInfection causes most of the deaths in patients with SLE-related PLE. High 24-hour urine protein level is an independent risk factor associated with death, and severe hypoalbuminemia is a predictor of disease flares.

show abstract