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2014 ; 93
(29
): e248
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Intestinal pseudo-obstruction in systemic lupus erythematosus: a case report and
review of the literature
#MMPMID25546663
Wang JL
; Liu G
; Liu T
; Wei JP
Medicine (Baltimore)
2014[Dec]; 93
(29
): e248
PMID25546663
show ga
Intestinal pseudo-obstruction (IPO) is a rare but dangerous complication of
systemic lupus erythematosus (SLE) when the patient has no other manifestations
except gastrointestinal symptoms. We performed 1 patient with a 2-month history
of recurrent vomiting and abdominal distension. She admitted past surgical
histories of cesarean section and appendectomy. A physical examination revealed
tenderness in the right lower abdominal on palpation and bowel sounds were weak,
2 to 3 bpm. An x-ray and CT of her abdomen showed intestinal obstruction. The
initial diagnosis was adhesive intestinal obstruction. She received surgical
treatment because her symptoms had gradually become more frequent and persistent.
But she vomited again 2 weeks later after the surgery. Further immunology tests
indicated that she had an IPO secondary to SLE. We treated the patient with
methylprednisolone pulse for 3 days and followed by prednisone orally. The
patient had a good response. Complete remission was achieved on 8 years
follow-up. The importance of IPO secondary to SLE lies in an early diagnosis.
After the diagnosis is established, immunosuppressive therapy should be the
initial and first-line treatment, and surgical intervention is often
disappointing and should be carefully avoided. It is necessary to enhance
awareness of doctors to IPO secondary to SLE.