Vol.22 No.2

Case Report

A patient with systemic lupus erythematosus who developed massive small intestinal hemorrhaging during treatment for chronic lupus peritonitis

Authors

Shin-ya Kawashiri1 , Ayako Nishino1 , Eijun Sueyoshi2 , Akitomo Okada1 , Tomohiro Koga1 , Satoshi Yamasaki1 , Hideki Nakamura1 , Tomoki Origuchi3 , Atsushi Kawakami1

  • Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
  • Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  • Nagasaki University School of Health Sciences, Nagasaki, Japan
Received:

29 March 2011

Accepted:

27 June 2011

Published online:

15 July 2011

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Abstract

A 50-year-old Japanese woman, a patient with systemic lupus erythematosus (SLE) complicated with chronic lupus peritonitis, developed massive small intestinal hemorrhaging. She was treated with intravenous pulse of methylprednisolone, intravenous pulse of cyclophosphamide (IVCY), and immunoabsorption, but the peritonitis was refractory to these treatments. Subsequently, she was treated with oral corticosteroid and tacrolimus, and received IVCY monthly, but she developed massive small intestinal hemorrhaging 1 year after. Abdominal angiography detected multiple bleeding sites from the jejunal and ileal arteries. After transarterial embolization treatment, the melena disappeared. The pathology of this case appeared to be lupus mesenteric vasculitis.

Key words

Systemic lupus erythematosus - Lupus peritonitis - Small intestinal hemorrhage - Lupus mesenteric vasculitis