Article: Lupus enteritis masquerading as Crohn's disease

Background: Systemic lupus erythematosus is an autoimmune disease which can affect multiple organs, resulting in significant mortality and morbidity. Lupus enteritis is one of the rare complications of SLE, defined as vasculitis of the intestinal tract, with supportive biopsy findings and/or image. However, lupus enteritis is seldom confirmed on histology or image and the changes of intestinal mucosa are nonspecific. Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract which affects any part of the gastrointestinal tract. The diagnosis of CD is confirmed by clinical evaluation and a combination of endoscopic, histology, radiology, and/or biochemical investigations.

Case Presentation: Here we report a rare case of a 71-years-old Chinese male has been diagnosed with lupus enteritis which similar to CD in the aspects of endoscopic, histology, and radiology. So far, there are no relevant cases reported.

Conclusions: The endoscopic appearance of lupus enteritis is nonspecific, on the basis of our case, the features of lupus enteritis can be described as spacious, clean and no moss ulcers which discontinuous involved all gastrointestinal tract.

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References

1.

Oshimo Y, Harada W, Kariya K . [A case of elderly man with systemic lupus erythematosus (SLE) associated with paralytic ileus and fistula formation]. Nihon Shokakibyo Gakkai Zasshi. 1999; 96(4):413-7. View

2.

Franchin G, Diamond B . Pulse steroids: how much is enough?. Autoimmun Rev. 2006; 5(2):111-3. DOI: 10.1016/j.autrev.2005.08.003. View

3.

Minordi L, Vecchioli A, Guidi L, Poloni G, Fedeli G, Bonomo L . CT findings and clinical activity in Crohn's disease. Clin Imaging. 2009; 33(2):123-9. DOI: 10.1016/j.clinimag.2008.08.021. View

4.

Tian X, Zhang X . Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment. World J Gastroenterol. 2010; 16(24):2971-7. PMC: 2890936. DOI: 10.3748/wjg.v16.i24.2971. View

5.

Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M . The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Definitions and diagnosis. J Crohns Colitis. 2010; 4(1):7-27. DOI: 10.1016/j.crohns.2009.12.003. View

6.

Katsanos K, Voulgari P, Tsianos E . Inflammatory bowel disease and lupus: a systematic review of the literature. J Crohns Colitis. 2012; 6(7):735-42. DOI: 10.1016/j.crohns.2012.03.005. View

7.

Murosaki T, Nagashima T, Matsumoto K, Minota S . Marked colonic wall thickening in lupus enteritis. Intern Med. 2012; 51(11):1451. DOI: 10.2169/internalmedicine.51.7585. View

8.

Janssens P, Arnaud L, Galicier L, Mathian A, Hie M, Sene D . Lupus enteritis: from clinical findings to therapeutic management. Orphanet J Rare Dis. 2013; 8:67. PMC: 3651279. DOI: 10.1186/1750-1172-8-67. View

9.

Kawalec P, Mikrut A, Wisniewska N, Pilc A . Tumor necrosis factor-α antibodies (infliximab, adalimumab and certolizumab) in Crohn's disease: systematic review and meta-analysis. Arch Med Sci. 2013; 9(5):765-79. PMC: 3832823. DOI: 10.5114/aoms.2013.38670. View

10.

Lisnevskaia L, Murphy G, Isenberg D . Systemic lupus erythematosus. Lancet. 2014; 384(9957):1878-1888. DOI: 10.1016/S0140-6736(14)60128-8. View

11.

Hochberg M . Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997; 40(9):1725. DOI: 10.1002/art.1780400928. View

Lupus Enteritis Masquerading As Crohn's Disease