Lupus enteritis: from clinical findings to therapeutic management. - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Orphanet Journal of Rare Diseases Year : 2013

Lupus enteritis: from clinical findings to therapeutic management.

Lionel Galicier
  • Function : Author
  • PersonId : 941136


Lupus enteritis is a rare and poorly understood cause of abdominal pain in patients with systemic lupus erythematosus (SLE). In this study, we report a series of 7 new patients with this rare condition who were referred to French tertiary care centers and perform a systematic literature review of SLE cases fulfilling the revised ACR criteria, with evidence for small bowel involvement, excluding those with infectious enteritis. We describe the characteristics of 143 previously published and 7 new cases. Clinical symptoms mostly included abdominal pain (97%), vomiting (42%), diarrhea (32%) and fever (20%). Laboratory features mostly reflected lupus activity: low complement levels (88%), anemia (52%), leukocytopenia or lymphocytopenia (40%) and thrombocytopenia (21%). Median CRP level was 2.0 mg/dL (range 0--8.2 mg/dL). Proteinuria was present in 47% of cases. Imaging studies revealed bowel wall edema (95%), ascites (78%), the characteristic target sign (71%), mesenteric abnormalities (71%) and bowel dilatation (24%). Only 9 patients (6%) had histologically confirmed vasculitis. All patients received corticosteroids as a first-line therapy, with additional immunosuppressants administered either from the initial episode or only in case of relapse (recurrence rate: 25%). Seven percent developed intestinal necrosis or perforation, yielding a mortality rate of 2.7%. Altogether, lupus enteritis is a poorly known cause of abdominal pain in SLE patients, with distinct clinical and therapeutic features. The disease may evolve to intestinal necrosis and perforation if untreated. Adding with this an excellent steroid responsiveness, timely diagnosis becomes primordial for the adequate management of this rare entity.
Fichier principal
Vignette du fichier
1750-1172-8-67.pdf (457.46 Ko) Télécharger le fichier
1750-1172-8-67-S1.DOC (67.5 Ko) Télécharger le fichier
1750-1172-8-67.xml (85.58 Ko) Télécharger le fichier
Origin : Publisher files allowed on an open archive
Format : Other
Format : Other

Dates and versions

inserm-00821479 , version 1 (10-05-2013)



Peter Janssens, Laurent Arnaud, Lionel Galicier, Alexis Mathian, Miguel Hie, et al.. Lupus enteritis: from clinical findings to therapeutic management.. Orphanet Journal of Rare Diseases, 2013, 8 (1), pp.67. ⟨10.1186/1750-1172-8-67⟩. ⟨inserm-00821479⟩
225 View
458 Download



Gmail Facebook Twitter LinkedIn More