The American Surgeon · 2000 · 26 citations · 9 references
MedicinePathologySurgeryImmunopathologyPediatric RheumatologyRheumatologyAutoimmune DiseasesAutoimmune VasculitisGastrointestinal InflammationGastrointestinal PathologyGastrointestinal PerforationSystemic Lupus ErythematosusEnteric InflammationEnteric PathologySmall Bowel PerforationSmall Bowel SurgerySteroid Therapy ManagementSystemic Lupus Erythematosus AssociationsVasculitis ComplicationsVasculitis Treatment
Bowel symptoms occur often in systemic lupus erythematosus (SLE), but enteric complications in patients on steroid therapy are rare. We report a case of a 14-year-old Mexican girl with SLE on high-dose steroid therapy complicated by abdominal vasculitis and small bowel perforation. Accompanying this serious complication were thrombocytopenia and radiographic changes of pneumatosis intestinalis. These findings suggested necrotizing enteritis and prompted urgent surgery. Four jejunal perforations, pneumatosis intestinalis, and submucosal vasculitis were present in the resected specimen. Persistent SLE activity responded to cyclophosphamide, which is indicated in patients with digestive symptoms who fail to respond to high-dose steroids.
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Acute Reversible Lupus Vasculitis of the Gastrointestinal Tract
Lorraine G. Shapeero, Allen R. Myers, Paul E. Oberkircher et al. · Radiology · 1974 · 76 citations