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Acute pancreatitis as the initial presentation of systematic lupus erythematosus.

Jia Y, Ortiz A, Mccallum R, Salameh H, Serrato P - Case Rep Gastrointest Med (2014)

Bottom Line: Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients.As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE.Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA.

ABSTRACT
Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

No MeSH data available.


Related in: MedlinePlus

Repeat contrast enhanced CT of the abdomen and pelvis at day 3 after admission revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel.
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fig2: Repeat contrast enhanced CT of the abdomen and pelvis at day 3 after admission revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel.

Mentions: Patient was admitted with a diagnosis of acute pancreatitis and supportive treatment was initiated. During the initial hospital course, the patient's clinical condition deteriorated. The patient developed shortness of breath and abdominal distention and the abdominal pain increased. Patient was found to have bloody stool. Interval PE revealed crackles at lung bases bilaterally. Patient had diffuse abdominal tenderness with absent bowel sound. Repeat contrast enhanced CT of the abdomen and pelvis revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel (Figure 2). There was a marked interval increase in volume of ascites and no evidence of focal pancreatic lesions or pseudocysts. Chest CT indicated an isolated segmental partial filling defect in the right middle lobe extending to the subsegmental branch and bilateral pleural effusion with lobar compressive atelectasis. There also was bilateral axillary lymphadenopathy described by the radiologist as likely reactive. Urinalysis of patient again was found to have blood and protein, with a urine sediment revealing dysmorphic RBC and RBC casts. A spot urine protein/creatinine ratio estimated a 24-hour proteinuria to be around 2.5 grams per day. Ranson's score increased from 1 at initial admission to 4 at the third day after admission. With the history of leg swelling and alopecia, further studies were done.


Acute pancreatitis as the initial presentation of systematic lupus erythematosus.

Jia Y, Ortiz A, Mccallum R, Salameh H, Serrato P - Case Rep Gastrointest Med (2014)

Repeat contrast enhanced CT of the abdomen and pelvis at day 3 after admission revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150433&req=5

fig2: Repeat contrast enhanced CT of the abdomen and pelvis at day 3 after admission revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel.
Mentions: Patient was admitted with a diagnosis of acute pancreatitis and supportive treatment was initiated. During the initial hospital course, the patient's clinical condition deteriorated. The patient developed shortness of breath and abdominal distention and the abdominal pain increased. Patient was found to have bloody stool. Interval PE revealed crackles at lung bases bilaterally. Patient had diffuse abdominal tenderness with absent bowel sound. Repeat contrast enhanced CT of the abdomen and pelvis revealed pneumatosis involving the distal jejunum, proximal ileum, and diffusely dilated small bowel loops as well as segmented submucosal thickening of the small bowel (Figure 2). There was a marked interval increase in volume of ascites and no evidence of focal pancreatic lesions or pseudocysts. Chest CT indicated an isolated segmental partial filling defect in the right middle lobe extending to the subsegmental branch and bilateral pleural effusion with lobar compressive atelectasis. There also was bilateral axillary lymphadenopathy described by the radiologist as likely reactive. Urinalysis of patient again was found to have blood and protein, with a urine sediment revealing dysmorphic RBC and RBC casts. A spot urine protein/creatinine ratio estimated a 24-hour proteinuria to be around 2.5 grams per day. Ranson's score increased from 1 at initial admission to 4 at the third day after admission. With the history of leg swelling and alopecia, further studies were done.

Bottom Line: Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients.As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE.Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA.

ABSTRACT
Systematic lupus erythematosus (SLE) is a multisystem disease, including the gastrointestinal system in about half of SLE patients. As a rare complication of SLE, acute pancreatitis presents as generalized flare-ups in most cases of patients previously diagnosed with SLE. Here we report a rare case of acute pancreatitis as the initial presentation with later diagnosis of SLE.

No MeSH data available.


Related in: MedlinePlus