A case of SLE with pancreatitis
DOI:
https://doi.org/10.18203/2320-6012.ijrms20174971Keywords:
Acute pancreatitis, Anasarca, Butterfly rash, Hypertriglyceridemia, Hypothyroidism, Lupus nephritis, Renal biopsy, SLEAbstract
Systemic lupus erythematosus (SLE) is a chronic, autoimmune inflammatory disease characterized by the presence of autoantibodies, immune complex formation, and multiple organ system involvement. Gastrointestinal manifestations are common in SLE patients, but acute pancreatitis is rare. Here we present a case of a 23 yrs. old male who came to the medicine OPD with the chief complaints of pain in abdomen, swelling all over the body since, 8 days and multiple joint pain for 1 and half months. On examination he was febrile pallor present with anasarca, periorbital edema with heliotrope around both eyes. Dry and xerotic ski over the face, butterfly rash present. Blood investigations, USG and CECT suggestive of acute panceatitis. Patient was treated in ICU for pancreatitis. Patient was found to be hypothyroid and treated with thyroid supplements. ANA BLOT was suggestive of SLE. Renal biopsy showed diffuse proliferative lupus nephritis. Hence our patient had pancreatitis possibly due to SLE induced hypertriglyceridemia.
References
Hahn BH. Harrisons principles of internal medicine, 19th edition, 2015:2124- 134.
Breuer GS, Baer A, Dahan D, Nesher G. Lupus associated pancreatitis. Autoimmunity Rev. 2006;5:314-8.
Derk CT, DeHoratius RJ. Systemic lupus erythematosus and acute pancreatitis: a case series. Clin Rheumatol. 2004 Apr;23(2):147-51.
Noia JL, Garc´ıa FM, R´ıos SS, Iglesias Garc´ıa J, and Dom´ınguez Mu˜noz JE. Pancreatitis an systemic lupus erythematosus. Revista Espanola de Enfermedades Digestivas. 2009;101(8):571-9.
Makol A, Petri M. Pancreatitis in systemic lupus erythematosus: frequency and associated factors: a review of the Hopkins Lupus Cohort. J Rheumatol. 2010;37(2):341-5.
Pascual-Ramos V, Duarte-Rojo A, Villa AR, Hernández-Cruz B, Alarcón-Segovia D, Alcocer-Varela J, Robles-Díaz G. Systemic lupus erythematosus as a cause and prognostic factor of acute pancreatitis. J Rheumatol. 2004;31(4):707-12.
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH, Austin A, Bell A, Bloch DA, Corey PN, Decker JL, Esdaile J. Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis Rheumatol. 1992;35(6):630-40.
Yang Y, Ye Y, Liang L, Wu T, Zhan Z, Yang X, Xu H. Systemic-lupus-erythematosus-related acute pancreatitis: a cohort from South China. Clinical and Developmental Immunology. 2012;2012.
Zhang X, Zeng XJ, Dong Y. Digestive system involvement in systemic lupus erythematosus. Chin J Dig. 1999;19(1):42-4.
Nesher G, Breuer GS, Temprano K, Moore TL, Dahan D, Baer A, Alberton J, Izbicki G, Hersch M. Lupus-associated pancreatitis. In Seminars in arthritis and rheumatism. WB Saunders. 2006;35(4):260-7.