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226 PSEUDO-OBSTRUCTION AND MESENTERIC VASCULITIS: AN INTERESTING GASTROINTESTINAL PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS C Gillis, M Champion Systemic lupus erythematosus (SLE) is a multisystem disease characterized by autoantibodies with variable tissue damage. Gastrointestinal symptoms are common in patients with SLE. However, in the undiagnosed patient with GI complaints the diagnosis is often overlooked which results in a high morbidity and mortality in selected cases. Mesenteric vasculitis is rare in SLE with a quoted 2% incidence, and is associated with a high mortality (50%). Previous studies have stated that steroid therapy is often not effective and further immunomodulatory drugs are required.
University of Ottawa
This is a case of a 21-year-old female previously undiagnosed with SLE who presented to hospital with abdominal pain. Previously she had two other admissions over a three-year period for similar complaints. During her admission she acutely developed symptoms compatible with a small bowel obstruction. CT scan did not reveal an obstruction but demonstrated diffuse small bowel thickening along its entire course consistent with mesenteric vasculitis. Accompanying her clinical deterioration was laboratory evidence of vasculitis and SLE. Both her clinical and laboratory status rapidly improved with corticosteroid therapy.
In conclusion, this young lady had multiple GI complaints over a three-year period prior to her diagnosis of SLE. She developed a pseudo-obstruction, and mesenteric vasculitis that responded remarkably to steroids.