Systemic lupus erythematosus (SLE): an unusual cause of ileocolic intussusception

Abstract

Intussusception is a rare diagnosis in adults. Gastrointestinal involvement is not unusual in systemic lupus erythematosus (SLE). A case of intussusception as first presenting symptom of SLE is described. A 50-year-old woman of Chinese origin came to the emergency room with symptoms of high fever, nausea, vomiting and weight loss of 10 kg. Three months before, an episode with abdominal pain due to ileal invagination in the colon occurred. Laboratory analysis showed: thrombocytopaenia, lymphopaenia, positive antinuclear antibody, antidouble-stranded DNA, Coombs tests and low C3 in combination with an active urine sediment and proteinuria. CT and positron emission tomography scan showed lymphadenopathy, but no other abnormalities. Axillar lymph node biopsy showed no abnormalities. The diagnosis new-onset SLE was made. Prednisone treatment was started and soon thereafter tapered, azathioprine and hydroxychloroquine were added. During follow-up, the SLE remained in remission. SLE is a rare cause of ileocolic intussusception and ileocolic intussusception may be the first presenting symptom.

Systemic lupus Erythematous as an Unusual Cause of Intussusception in Sudanese Woman: Case report

“…An intussusception itself as a complication or presenting symptom of SLE is rare, until now there are no more than seven cases have been reported in SLE (4,6). Two of those cases it was secondary to mesenteric vacuities and five cases had an intussusception as an initial presentation of SLE (7). In this case, we are reporting a case of SLE with intussusception as the initial presentation.…”

Systemic lupus erythematous as an unusual cause of intussusception in Sudanese woman: A case report

“…Only seven cases of intussusception in patients with SLE have been described in the literature. Four cases were secondary to LMV, 7 one of them, lymphadenopathy was the main cause, one was related to Burkitt’s lymphoma, one was secondary to changes in the peristalsis of the edematous small intestine. 4 , 7 , 13 , 14 …”

“… 4 , 6 Two of those cases were secondary to mesenteric vacuities and five cases had an intussusception as an initial presentation of SLE. 7 In this case, we are reporting a case of SLE with intussusception as the initial presentation.…”

Mesenteric vasculitis as a rare initial presentation of systemic lupus erythematosus: A case report

“…[ 9 10 ] Such relapses can be treated with pulse steroids and cyclophosphamide as well as biologic therapy. [ 16 17 18 19 ]…”

“…In terms of management, treatment with pulse cyclophosphamide and immunoglobins has shown to be a useful modality. [ 9 10 17 18 19 ]…”