A Case of 300 Pound Weight Loss, Malabsorption, Malnutrition, and Protein-Losing Enteropathy Due to Systemic Lupus Erythematosus of the Small Intestine
September 2007
in “
The American Journal of Gastroenterology
”
Systemic Lupus Erythematosis SLE malabsorption malnutrition protein losing enteropathy hair loss anasarca albumin deficiency zinc deficiency vitamin A deficiency vitamin D deficiency TPN total parenteral nutrition IV solumedrol prednisone azathioprine lupus IV steroids oral steroids immunosuppressants
TLDR Recognizing lupus as a cause of severe gut issues is crucial for effective treatment.
This case study reported a 55-year-old female with Systemic Lupus Erythematosis (SLE) who experienced severe malabsorption, malnutrition, and a 300-pound weight loss over three years, alongside chronic diarrhea and small bowel obstruction. Initial tests showed nonspecific colitis and ineffective dietary changes. Her condition included non-patchy hair loss, anasarca, and a BMI drop from 72 to 14. Lab results indicated low hemoglobin, elevated CRP, and deficiencies in albumin, zinc, and vitamins A and D. A CT scan and EGD revealed pleural effusions, ascites, and small bowel abnormalities inconsistent with Celiac disease. Despite treatment with TPN, her condition worsened, leading to ICU admission. SLE was confirmed through serology, and small bowel resection showed full thickness inflammation. Treatment with IV solumedrol and TPN improved her condition, allowing discharge on oral prednisone and azathioprine. This case highlighted the importance of recognizing SLE-related small bowel inflammation for effective treatment and improved survival.
