Systemic lupus erythematosus presenting with eosinophilic enteritis: a case report

Abstract

IntroductionSystemic lupus erythematosus (SLE) is a multisystem disorder that may present with various symptoms. It may involve the gastrointestinal tract in a variety of ways; some of the most well-known ones are transaminitis, lupus mesenteric vasculitis, lupus enteritis and mesenteric vascular leakage. We describe a case of a patient with SLE who presented with a five-month history of diarrhea caused by eosinophilic enteritis. To the best of our knowledge, there are few cases reported in the literature of patients with SLE who initially present with chronic diarrhea due to eosinophilic enteritis.Case presentationA 38-year-old Persian Iranian woman was admitted with a five-month history of diarrhea and abdominal pain. A physical examination showed nothing abnormal. Initially, she had only lymphopenia and mild eosinophilia. No autoimmune or infectious etiology was detected to justify these abnormalities. A thorough evaluation was not helpful in finding the etiology, until she developed a scalp lesion similar to discoid lupus erythematosus. Computed tomography showed small bowel wall thickening. Briefly, she manifested full-blown SLE, and it was revealed that the diarrhea was caused by eosinophilic enteritis.ConclusionConsidering SLE in a patient who presents with chronic diarrhea and lymphopenia may be helpful in earlier diagnosis and therapy. This is an original case report of interest to physicians who practice internal medicine, family medicine and gastroenterology.

Acute eosinophilic ascites: An unusual form of an unusual case

“…9,10 We also found a similar case report of a lady with EA with ANA positivity, who subsequently developed SLE. 11 Our patient is being closely followed but has shown no symptoms of any connective tissue disorder; his very strong positivity to ANA is still an enigma.…”

An Unusual Case of Eosinophilia with Systemic Lupus Erythematosus: A Case Report and Review of Literature

“…Several reports have described eosinophilic vasculitis [6], eosinophilic gastroenteritis [7,8], Loffler's endocarditis [9,10], eosinophilic pruritic cutaneous lesions [11], and nonerosive arthritis [12] in patients with systemic lupus erythematosus. All of the cases possessed diagnostic difficulty due to the rarity of the case.…”

“…All of the cases possessed diagnostic difficulty due to the rarity of the case. In most of the reported cases of SLE with eosinophilia, it was treated with high-dose corticosteroids and/or immunomodulators, and all cases Fever, diarrhea, and vomiting along with a preceding history of fatigue and flitting polyarthralgia involving the wrists, hands, and feet SLE, with hypereosinophilia, acalculous cholecystitis, and biopsy-proven eosinophilic vasculitis affecting the kidney ree consecutive pulses of methylprednisolone (1 g/24 h) Significant improvement Asadi Gharabaghi et al [7] Five-month history of diarrhea and abdominal pain, scalp lesion similar to discoid lupus erythematosus.…”