Lupus-associated pancreatitis

Breuer, Gabriel S.; Baer, Asher; Dahan, David; Nesher, Gideon

doi:10.1016/j.autrev.2005.11.004

Cited by 81 publications

(116 citation statements)

References 24 publications

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“…A recent review article cited 77 case reports of acute idiopathic pancreatitis in the literature. 9 The median age was 27 and 88% were female. Most of the patients (84%) had active lupus at the time of pancreatitis.…”

Section: Small and Large Bowelmentioning

confidence: 99%

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Daruwala

Mercogliano

Harder

2009

Clinical Medicine. Gastroenterology

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Abstract:In this review, we analyze the effects of systemic lupus erythematosus and scleroderma on the gastrointestinal tract. There is a wide variation of gastrointestinal manifestations from these autoimmune disorders including but not limited to: oral ulcers, dysphagia, gastroesophageal refl ux disease, abdominal pain, constipation, diarrhea, fecal incontinence, pseudo-obstruction, perforation and gastrointestinal bleeding. The purpose of this review is to discuss these manifestations, the appropriate diagnostic tests, and treatment.Keywords: systemic lupus erythematosus, scleroderma, gastrointestinal manifestations Systemic Lupus ErythematosusSystemic Lupus Erythematosus (SLE) is a multisystem disease characterized by antinuclear antibodies and complement deposition. The disease affects women more then men (especially African-American women) with a reported female/male ratio of 10:1.1 Gastrointestinal (GI) complications are common in patients with active SLE. In 1895, William Osler was the fi rst to describe how the GI complications of SLE can mimic any type of abdominal condition and overshadow the other organ complications associated with SLE. Gastrointestinal complications can lead to a variety of symptoms across a large portion of the GI tract. Up to 50% of patients will experience anorexia, nausea or vomiting. Oral Cavity and SLEOral or nasopharyngeal ulceration, usually painless, observed by a physician is one of the eleven diagnostic criteria of SLE. Mucous membrane involvement occurs in 12%-45% of patients. The wide variation may be explained by demographic differences. One cross-sectional analysis reported that 46% of English patients with SLE had oral lesions compared to 15% of patients in Brazil and 11% of patients in Sweden.2 Another study reported oral ulcerations at a prevalence of 26% in an Arab population of SLE patients, and noted a signifi cant association with the presence of anti-smith antibodies (P = 0.033). 3Causes of the mucosal ulcerations include the underlying disease activity, associated Sjogren's syndrome, intra-oral infections and complications associated with treatment.The ulcers are generally classifi ed as either discoid, erythematous or ulcerative. Discoid lesions, characterized by erythema, atrophy, and depigmentation, usually occur on the lips. Punched-out erosions/ ulcers with surrounding erythema, irregularly shaped raised white plaques, and areas of erythema tend to occur on the hard or soft palate and the buccal mucosa. The discoid lesions are painful while the erythematous lesions (the majority) are painless. It has been reported by Jonsson et al that only those patients with active disease can have ulcerative and discoid lesions. However, they found no correlation between overall prevalence of oral lesions and SLE disease activity. 4 The treatment options for oral lesions include topical glucocorticoids, tacrolimus ointment, intralesional corticoids, and systemic antimalarial drugs. Most lesions respond to steroids in days to weeks. EsophagusDysphagia occurs in 1.5%-1...

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Section: Small and Large Bowelmentioning

confidence: 99%

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Daruwala

Mercogliano

Harder

2009

Clinical Medicine. Gastroenterology

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“…Derk CT et al [4] studied cases of LP patients reported by Thomas Jefferson University during 1982-2002, and concluded that LP accounted for 0.85%, 76% of which were in the active stage of SLE; The number of organs involved was at an average of 4.4 (renal diseases accounted for 56%, hydrothorax 48%, arthritis 44%); 82% of patients were relieved of symptoms clinically and laboratorially after using a large dose of hormones, which cannot aggravate AP. Breuer GS et al [5] reported that the annual incidence of LP was 0.4‰-1.1‰, 80% of which were women; 97% of diagnoses depended on the measurement of serum amylase (blood amylase) and lipase. This disease had no correlation with hormones + azathioprine.…”

Section: Discussionmentioning

confidence: 99%

“…A large amount of researches have shown that hormones are more effective when combined with immunosuppressants (cyclophosphamide, mycophenolate mofetil and azathioprine) in the treatment and prognosis of LP. [17][18][19][20][21][22] The patient in this case was given hormones with combination of cyclophosphamide and hydroxychloroquine, and then relieved of symptoms. A case report abroad showed that single use of CD20 (mAb) [23] or combined use of CD20 and CTX [24] can relieve the symptoms in a short time and prevent from side effects (e.g.…”

Section: The Treatment Of Lpmentioning

confidence: 99%

A report of systemic lupus erythematosus accompanying acute pancreatitis

Shi

Wang

2016

DCC

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Objective: Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease, in which multiple organs are involved. Lupus with pancreatitis (LP) is a rare disease. It is an effective strategy for clinical work to comprehensively study the pathogenesis, diagnosis and treatment of LP. Methods: A report of 42-year-old female patient with intermittent arthralgia more than 10 years, rash, edema on double lower limbs for 7 years. The patient's condition was worsened for 10 days, given a diagnosis of SLE nausea, vomiting and abdominal pain after admission. Examinations: blood amylase 612 U/L, urine amylase 3,345 U/L. Ultrasound: pancreas swelled with a change in texture, with ascites (medium). Considered as severe acute pancreatitis, the patient was given treatment with 80 mg methylprednisolone qd, 0.2 g cyclophosphamide ivgtt qod, fasting. It was required of gastrointestinal decompression, acid suppression, somatostatin inhibiting pancreatic secretion, anti-inflammatory treatment, intraperitoneal perfusion of antibiotics and other symptomatic treatments. The symptoms were relieved after 18 days. Results: Hormones were selected and combined with immunosuppressants to relieve symptoms with the aid of gastrointestinal decompression, acid suppression, somatostatin and anti-inflammatory therapy. Conclusions: It is critical to summarize the characteristics of LP, diagnose early and give individualized treatment in order to relieve LP.

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“…Se ha descrito que la mortalidad de la pancreatitis lúpica, es de un 27% mayor a la observada en la pancreatitis no asociada a esta enfermedad (76). El compromiso hepático puede llevar a una enfermedad grave como por ejemplo cirrosis hepática, hepatitis crónica activa, hepatitis granulomatosa, hepatitis crónica persistente y esteatosis; siendo esta última la lesión más común observada en el LES.…”

Section: Manifestaciones Gatrointestinalesunclassified

Clinical and laboratory manifstations in Systemic Lupus Erythematosus

Colmán

Ávila

Acosta

et al. 2016

Mem. Inst. Investig. Cienc. Salud

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A, Centurión O, Duarte M.Manifestaciones clínicas y laboratoriales en el Lupus Eritematoso Sistémico. Mem. Inst. Investig. Cienc. Salud. 2016;14(1):94-109. R E S U M E NEl Lupus eritematoso sistémico (LES) es una enfermedad autoinmune compleja que se caracteriza por su capacidad de afectar a diversos órganos, lo que determina las diferentes manifestaciones clínicas objetivadas durante la evolución de la enfermedad. De forma asociada se ha descrito que estas manifestaciones presentan una variación geográfica o étnica, siendo por lo general menos grave en pacientes con ascendencia europea que en aquellos que presentan ascendencia africana, asiática o hispana. Alteraciones, tanto del sistema inmune adaptativo (células T y B) como del innato (Toll like receptorx-TLR), contribuyen al desarrollo del LES. Las células B tienen su papel en la producción de los autoanticuerpos (i.e. anticuerpos anti-ADN y anticuerpos antinucleosoma) y de determiandas citocinas. Las pruebas de laboratorio son de gran valor cuando se evalúa a un paciente con sospecha de enfermedad autoinmune. Los resultados pueden confirmar el diagnóstico, estimar la severidad de la enfermedad, evaluar el pronóstico y son de suma utilidad para el seguimiento de la actividad del LES.Palabras clave: manifestaciones clínicas, lupus eritematoso sistémico, análisis laboratoriales Clinical and laboratory manifstations in Systemic Lupus Erythematosus A B S T R A TSystemic Lupus Erythematosus (SLE) is a complex autoimmnune disease characterized by its ability to affect different organs, which determines different clinical manifestations observed during the course of the disease. It has been described that these manifestations have geographic or ethnic varations being generally less serious in patients of European descent than in those with African, Asian or Hispanic descents. Alterations of both the adaptative (T and B cells) and innate (Toll like receptorx-TLR) immnune systems contribute to the development of SLE. B cells have a role in the production of autoantibodies (i.e. anti-DNA and anti-nucleosome antibodies) and some cytokines. Laboratory tests are invaluable when evaluating a patient with suspected autoimmune disease. The results can confirm the diagnosis, estimate the severity of the disease, assess prognosis and are extremely useful for monitoring the activity of SLE.

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Lupus-associated pancreatitis

Cited by 81 publications

References 24 publications

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

A report of systemic lupus erythematosus accompanying acute pancreatitis

Clinical and laboratory manifstations in Systemic Lupus Erythematosus

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