Case Report

Intestinal Pseudo-obstruction as a Presenting Manifestation of Systemic Lupus Erythematosus: Case Report and Review of the Literature

Authors: Hien Nguyen, MD, Niharika Khanna, MD

Abstract

A case of intestinal pseudo-obstruction as a presenting manifestation of systemic lupus erythematosus is presented. Systemic lupus erythematosus is an autoimmune disease with a wide spectrum of unpredictable multisystemic presentations. A case of systemic lupus erythematosus that was diagnosed in a patient whose initial presentation for the disease was acute renal failure, hydronephrosis, intestinal pseudo-obstruction, and false-positive syphilis serologies is presented. There have been 18 other cases of intestinal pseudo-obstruction associated with systemic lupus erythematosus to date in the English literature. A variety of gastrointestinal syndromes have been increasingly recognized as possible manifestations of systemic lupus erythematosus, and this case illustrates in particular that intestinal pseudo-obstruction may be a presenting manifestation of this disorder.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Klippel JH. Systemic lupus erythematosus: Demographics, prognosis, and outcome. J Rheumatol Suppl 1997; 48: 67–71.
 
2. Nojima Y, Mimura T, Hamasaki K, et al. Chronic intestinal pseudoobstruction associated with autoantibodies against proliferating cell nuclear antigen. Arthritis Rheum 1996; 39: 877–879.
 
3. Mok MY, Wong RW, Lau CS. Intestinal pseudo-obstruction in systemic lupus erythematosus: An uncommon but important clinical manifestation. Lupus 2000; 9: 11–18.
 
4. Perlemuter G, Chaussade S, Wechsler B, et al. Chronic intestinal pseudo-obstruction in systemic lupus erythematosus. Gut 1998; 43: 117–122.
5. Feldman M, Friedman LS, Sleisenger MH (eds): Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. Philadelphia, W.B. Saunders, 1998, vol 2, ed 6, pp 1821–1830.
 
6. Cacoub P, Benhamou Y, Barbet P, et al. Systemic lupus erythematosus and chronic intestinal pseudoobstruction. J Rheumatol 1993; 20: 377–381.
 
7. Sandgren JE, McPhee MS, Greenberger NJ. Narcotic bowel syndrome treated with clonidine: Resolution of abdominal pain and intestinal pseudo-obstruction. Ann Intern Med 1984; 101: 331–334.
 
8. Perlemuter G, Cacoub P, Chaussade S, et al. Octreotide treatment of chronic intestinal pseudoobstruction secondary to connective tissue diseases. Arthritis Rheum 1999; 42: 1545–1549.