Gastrointestinal manifestations in systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by multisystem involvement, including the gastrointestinal (GI) tract. There is a significant variation in the clinical presentation and severity of GI disorders. When GI symptoms present as the initial manifestation of SLE, there is likely to be a delay in the diagnosis. The cause of these GI manifestations in SLE may be the disease, or the side effects of medications, or infections. In this study we investigated the GI manifestations in a group of SLE patients. Our study was conducted on 40 SLE patients and 30 healthy controls to assess the prevalence of GI symptoms in SLE patients. The prevalence of gastrointestinal manifestations in our study was 42.5%. GI manifestations in our SLE patients were: acute abdominal pain (due to pleurisy and peritonitis), 6%; diffuse abdominal pain, 23.5%; epigastric pain, 29%; epigastric pain with vomiting, 23.5%; epigastric pain with chronic constipation, 6%; chronic constipation, 6%; and diffuse abdominal pain with bleeding per rectum, 6%. In our study, we found a higher incidence of Giardia infestation in SLE patients than in healthy controls, and 10% of these patients were asymptomatic. There was more Giardia infestation in patients with GI symptoms as compared with patients with no GI symptoms, with a P value of 0.009. In our study SLE patients with GI symptoms had a peak systolic velocity (cm/s) with a mean of 108.4 ± 32.1 standard deviation (SD) in the celiac Doppler study. Patients without GI symptoms had a peak systolic velocity with a mean of 111.9 ± 37.7 SD, meaning that our patients mostly had no evidence of celiac trunk stenosis, but there was significant difference between SLE patients without GI symptoms and controls, as the mean was higher in SLE patients than in the controls. Also, the celiac end diastolic velocity was higher in both groups of SLE patients with GI symptoms and those without GI symptoms, compared to controls.

The Contribution of Drugs and Helicobacter pylori to Gastric Mucosa Changes in Patients with Systemic Lupus Erythematosus and Antiphospholipid Syndrome

“…The reasons why pain syndrome was more frequently detected in patients with APS may be associated with vascular changes [40, 42]. According to Fawzy et al, gastrointestinal manifestations were detected in 42.5% of SLE patients, while 6% of patients were found to have acute abdominal pain due to pleuritis or peritonitis in the presence of SLE activity [37]. Yuan et al performed retrospective cohort study of SLE patients with complaint of abdominal pain.…”

A report of chronic intestinal pseudo-obstruction related to systemic lupus erythematosus

“…SLE involves multiple systems, and the prevalence of gastrointestinal manifestations is reported by 42.5% [ 7 ]. When GI symptoms are similar to initial manifestation of SLE, there tend to be a delayed diagnosis.…”

“…This patient’s renal pathology resulted as active focal lupus nephritis with membranous lupus nephritis (Class III-(A)+V) ( Figure 2 ). Based on her clinical results and references [ 3 , 4 , 6 , 7 , 8 ], we considered that her ileus symptoms could be related to SLE. Therefore we performed enteroscopy along with intestinal biopsy and expected to find intestinal vasculitis.…”

The Value of Screening for Celiac Disease in Systemic Lupus Erythematosus: A Single Experience of a Tertiary Medical Center

“…Gastrointestinal manifestations are common among SLE patients because of the disease itself, as a consequence of infection, or because of side effects of medications. These manifest in a wide spectrum, including recurrent abdominal pain, vomiting, malabsorption, enteritis, pancreatitis, and others [ 1 – 3 ]. T-cell-induced immune-mediated disease triggered by gluten-containing food ingestion is known to be a cause of celiac disease (CD) among genetically predisposed individuals [ 4 ].…”