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2017 ; 96
(27
): e7478
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Successful treatment using corticosteroid combined antibiotic for acute
acalculous cholecystitis patients with systemic lupus erythematosus
#MMPMID28682919
Liu W
; Chen W
; He X
; Qu Q
; Hong T
; Li B
Medicine (Baltimore)
2017[Jul]; 96
(27
): e7478
PMID28682919
show ga
There is no consensus of treatments for acute acalculous cholecystitis with
systemic lupus erythematosus (SLE). The study was aimed to investigate the effect
of the corticosteroid for these patients.A series of patients who were diagnosed
as acute acalculous cholecystitis with SLE in the period from January 2012 to
December 2016 at our hospital were included. They accepted 2 different
conservative treatment strategies initially: the treatment using moxifloxacin
(the antibiotic group), and the treatment using corticosteroid combined
moxifloxacin (the corticosteroid group). Then clinical manifestations, laboratory
features, and outcomes were analyzed.The study identified 22 women Han Chinese
patients with the SLE history of 2.8?±?1.4 year. There was no significant
difference in SLE history, Systemic Lupus Erythematosus Disease Activity
Index-2000 (SLEDAI-2000), Systemic Lupus International Collaborating
Clinics/American College of Rheumatology damage index (SLICC/ACR), hematologic
examination results, and corticosteroid dosage between 2 groups. And there was no
significant difference in the symptom of acute cholecystitis, duration of the
symptoms, white blood level, and the thickness of gallbladder wall between 2
groups either. However, the SLEDAI-2000 of the corticosteroid group was lower
than that of the antibiotic group (7.3?±?1.4 vs 10.7?±?3.0, P?=?.03), so was the
SLICC/ACR (0.1?±?0.3 vs 0.3?±?0.5, P?=?.01). Moreover, total 11 of 12 patients
were successfully treated in the corticosteroid group, only 1 patient got
cholecystectomy because no improvement after conservative treatment. While 4 of
10 patients were successfully treated by moxifloxacin alone, 6 patients had to
accept cholecystectomy in the antibiotic group. The rate of successful
conservative treatment in the corticosteroid group was higher than that of the
antibiotic group (P?=?.02). All patients were followed up at least 6 months,
there was no statistical difference in the rate of recurrence of abdominal pain
between 2 groups (P?=?.37).The corticosteroid plays an important role in the
management of the acalculous cholecystitis patient with SLE, and it should be
considered as a first line of treatment.