Intestinal Pseudoobstruction Associated With Eosinophilic Enteritis as the Initial Presentation of Systemic Lupus Erythematosus in Children

Yamazaki‐Nakashimada, Marco Antonio; Rodrı́guez-Jurado, Rodolfo; Ortega-Salgado, Arturo; Gutiérrez-Hernández, Alonso; García-Pavon-Osorio, Susana; Hernández-Bautista, Víctor Manuel

doi:10.1097/mpg.0b013e31816b6b7b

Cited by 20 publications

(7 citation statements)

References 21 publications

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“…IPO secondary to SLE is rare: we identified 39 cases in the literature. Including the new case, IPO secondary to SLE has been reported in 37 female, 4 – 24 and 3 male, 15 , 25 , 26 yielding a female to male sex ratio of 12.3. Mean age of the patients at diagnosis was 32.5 (10–57) years.…”

Section: Resultsmentioning

confidence: 77%

“… 4 , 5 , 8 – 10 , 12 , 15 , 16 , 24 , 26 Gastrointestinal symptoms were the initial manifestation of SLE in 16 patients, 4 , 8 – 10 , 12 , 15 , 16 , 22 , 24 , 26 11 cases (69%) of them were misdiagnosed. 8 , 10 , 12 , 15 , 16 , 24 , 26 While only 5 cases (21%) were misdiagnosed in other 24 patients. 4 , 8 , 9 , 22 , 25 The patients whose initial manifestation was gastrointestinal symptoms were more likely to be misdiagnosed ( P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Eleven patients (28%) received surgical treatment as the initial treatment, 10 , 15 , 16 , 26 all of them were relapsed after surgery, and 6 of them relapsed in several weeks, 2 patients relapsed in 1 year after surgery, the others did not describe the exact time. When the diagnosis of IPO secondary to SLE was established, all the patients received corticosteroids treatment and had a good response to the corticosteroids treatment.…”

Section: Resultsmentioning

confidence: 99%

“…Notably, 10 patients (63%) had a surgery in patients whose initial manifestation were gastrointestinal symptoms, 8 , 10 , 15 , 16 , 24 – 26 6 patients had an unnecessary surgery, 15 , 16 , 25 and 3 patients had once more unnecessary surgery because of misdiagnosis. 8 , 15 , 26 Only 1 patient received surgery because of small bowel perforation. 15 After the diagnosis was established, all of the 10 patients received corticosteroids treatment and had a good response.…”

Section: Resultsmentioning

confidence: 99%

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Intestinal Pseudo-Obstruction in Systemic Lupus Erythematosus

Wang

Liu

et al. 2014

Medicine

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Intestinal pseudo-obstruction (IPO) is a rare but dangerous complication of systemic lupus erythematosus (SLE) when the patient has no other manifestations except gastrointestinal symptoms. We performed 1 patient with a 2-month history of recurrent vomiting and abdominal distension. She admitted past surgical histories of cesarean section and appendectomy. A physical examination revealed tenderness in the right lower abdominal on palpation and bowel sounds were weak, 2 to 3 bpm. An x-ray and CT of her abdomen showed intestinal obstruction. The initial diagnosis was adhesive intestinal obstruction. She received surgical treatment because her symptoms had gradually become more frequent and persistent. But she vomited again 2 weeks later after the surgery. Further immunology tests indicated that she had an IPO secondary to SLE. We treated the patient with methylprednisolone pulse for 3 days and followed by prednisone orally. The patient had a good response. Complete remission was achieved on 8 years follow-up.The importance of IPO secondary to SLE lies in an early diagnosis. After the diagnosis is established, immunosuppressive therapy should be the initial and first-line treatment, and surgical intervention is often disappointing and should be carefully avoided. It is necessary to enhance awareness of doctors to IPO secondary to SLE.

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Section: Resultsmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Intestinal Pseudo-Obstruction in Systemic Lupus Erythematosus

Wang

Liu

et al. 2014

Medicine

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“…Several medications can also mimic pseudo-obstruction, e. g., opiates and antidepressants [10]. Autoimmune diseases associated with CIPO are sclerodermia [11], systemic lupus erythematosus [12,13], polymyositis and dermatomyositis [14]. These are often accompanied by serological markers or typical clinical signs of the respective disease.…”

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confidence: 99%

Raising Awareness about Chronic Intestinal Pseudo-Obstruction (CIPO): A Case Report Showing CIPO as Initial Manifestation of Atypical Seronegative Systemic Sclerosis

et al. 2012

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Only few case studies address pseudo-obstruction, a disorder - which often frustrates clinicians and patients due to an unclear diagnosis and limited therapeutic options. Thus, the aim of this paper is to investigate a relevant case concerning a patient presenting with symptoms of acquired chronic intestinal pseudo-obstruction (CIPO). After one year of extensive diagnostic tests and unsuccessful treatment with prokinetics, the patient underwent a subtotal ileocolectomy. The histology of the intestinal specimen revealed continuous atrophy and fibrosis mainly within the circular, inner muscle layer of muscularis propria of the ileum and colon. Even though serum markers were lacking, a subsequent skin biopsy showed signs of scleroderma supporting an initial diagnosis of intestinal involvement in systemic sclerosis. Despite treatment with steroids and methotrexate, the increasingly emaciated patient died. In conclusion, there is a bias against the publishing of pseudo-obstruction studies, in particular, due to the obscure underlying causes. To raise awareness of this problem, we call for clinicians to systematically generate comprehensive data about patients presenting these symptoms.

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Eosinophilic Enteritis

DeBrosse¹,

Zuo²

2010

Diarrhea

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Intestinal Pseudoobstruction Associated With Eosinophilic Enteritis as the Initial Presentation of Systemic Lupus Erythematosus in Children

Cited by 20 publications

References 21 publications

Intestinal Pseudo-Obstruction in Systemic Lupus Erythematosus

Intestinal Pseudo-Obstruction in Systemic Lupus Erythematosus

Raising Awareness about Chronic Intestinal Pseudo-Obstruction (CIPO): A Case Report Showing CIPO as Initial Manifestation of Atypical Seronegative Systemic Sclerosis

Eosinophilic Enteritis

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