Lupus mesenteric vasculitis can cause acute abdominal pain in patients with SLE
- 1 May 2009
- journal article
- review article
- Published by Springer Nature in Nature Reviews Rheumatology
- Vol. 5 (5), 273-281
- https://doi.org/10.1038/nrrheum.2009.53
Abstract
Lupus mesenteric vasculitis (LMV) is a unique clinical entity found in patients who present with gastrointestinal manifestations of systemic lupus erythematosus, and is the main cause of acute abdominal pain in these patients. LMV usually presents as acute abdominal pain with sudden onset, severe intensity and diffuse localization. Other causes of abdominal pain, such as acute gastroenteritis, peptic ulcers, acute pancreatitis, peritonitis, and other reasons for abdominal surgery should be ruled out. Prompt and accurate diagnosis of LMV is critical to ensure implementation of appropriate immunosuppressive therapy and avoidance of unnecessary surgical intervention. The pathology of LMV comprises immune-complex deposition and complement activation, with subsequent submucosal edema, leukocytoclastic vasculitis and thrombus formation; most of these changes are confined to small mesenteric vessels. Abdominal CT is the most useful tool for diagnosing LMV, which is characterized by the presence of target signs, comb signs, and other associated findings. The presence of autoantibodies against phospholipids and endothelial cells might provide information about the likelihood of recurrence of LMV. Immediate, high-dose, intravenous steroid therapy can lead to a favorable outcome and prevent serious complications such as bowel ischemia, necrosis and perforation.Keywords
This publication has 111 references indexed in Scilit:
- Acute abdominal pain in systemic lupus erythematosus: factors contributing to recurrence of lupus enteritisAnnals Of The Rheumatic Diseases, 2006
- Elevated serum IgA anticardiolipin antibody levels in adult Henoch-Schönlein purpuraBritish Journal of Dermatology, 2006
- Mesenteritis precedes vasculitis in the rat mesentery after subacute administration of a phosphodiesterase type 4 inhibitorToxicology Letters, 2006
- Systemic lupus erythematosus associated with recurrent lupus enteritis and peritonitisClinical Rheumatology, 2004
- CMV enteritis causing ileal perforation in underlying lupus enteritisClinical Rheumatology, 2003
- Anti-endothelial cell antibody binding makes negatively charged phospholipids accessible to antiphospholipid antibodiesArthritis & Rheumatism, 1998
- Activation of Endothelial Cells in Thrombosis and VasculitisScandinavian Journal of Rheumatology, 1997
- A Seldom Recognized Cause of Intestinal IschemiaThe American Journal of Surgical Pathology, 1994
- CARDIOVASCULAR LESIONS IN SPRAGUE‐DAWLEY RATS INDUCED BY LONG‐TERM TREATMENT WITH CAFFEINEActa Pathologica Microbiologica Scandinavica Section A Pathology, 1981
- LATE INTESTINAL STENOSIS FOLLOWING STRANGULATED HERNIAAnnals of Surgery, 1928