41. Enteritis as initial manifestation of systemic lupus erythematosus: A case report

Luong Thi Phuong, Nguyen Thi Bich Ngoc, Nguyen Thu Huong

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Abstract

Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). However, the diagnosis is difficult, especially without other symptoms related to active SLE. We report a case of an 11-year-old female child who came to our hospital because of abdominal pain, vomiting a lot, and diarrhea 3 - 4 times/day, with no bloody mucus. The child was conscious, the abdomen was soft with no abdominal wall reaction, X- Abdominal radiographs were normal, and abdominal ultrasound showed thickening of some intestinal walls, little fluid. After 1 week, the child vomited more, vomited green and yellow fluid, had diarrhea with little mucus and no blood 12 - 15 times/day, and had a fever. Abdominal CT scan showed diffuse wall thickening of the small intestine and colon, lots of free fluid, fecal leukocytes (+), lymphocytopenia, normal CRP, C3, and C4 decreased sharply, ANA (+), anti-dsDNA increased, and proteinuria. The child was diagnosed with lupus enteritis/lupus nephritis and responded well to corticosteroid therapy after 2 weeks. This case emphasized the clinical features of lupus enteritis, diagnosis, and treatment.

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References

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