An Atypical Initial Manifestation of Systemic Lupus Erythematosus: Lupus Enteritis Accompanied by Intestinal Pseudo-Obstruction and Bilateral Hydronephroureter
December 2023
in “
Curēus
”
systemic lupus erythematosus lupus enteritis intestinal pseudo-obstruction hydronephroureter alopecia photosensitivity malar rash discoid rash neuropsychiatric lupus anti-nucleosome antibodies anti-Ro antibodies anti-La antibodies methylprednisolone hydroxychloroquine cyclophosphamide SLE IPO hair loss sun sensitivity steroid Plaquenil Cytoxan
TLDR A woman with lupus had rare severe symptoms but improved with treatment.
A 36-year-old Pakistani woman presented with a rare and severe initial manifestation of systemic lupus erythematosus (SLE), characterized by lupus enteritis, intestinal pseudo-obstruction (IPO), and bilateral hydronephroureter. She exhibited symptoms including fever, weight loss, recurrent diarrhea, vomiting, alopecia, and photosensitivity, along with a malar and discoid rash, and neuropsychiatric lupus. Laboratory tests showed positive anti-nucleosome, anti-Ro, and anti-La antibodies, among other markers. She was treated with intravenous methylprednisolone, hydroxychloroquine, and cyclophosphamide, leading to significant clinical and cognitive improvement. This case highlights the diagnostic and therapeutic challenges posed by atypical SLE manifestations, which can mimic other conditions like intestinal tuberculosis.
