An Unusual Case of Lymphocytic Enterocolitis and Vasculitis as the Initial Manifestation of Systemic Lupus Erythematosus

This case report describes a 69-year-old woman who presented with persistent watery diarrhea and significant weight loss, which was later identified as lymphocytic enterocolitis (LE), a rare initial manifestation of Systemic Lupus Erythematosus (SLE). Despite normal initial gastrointestinal tests, further investigation revealed mucosal ulcers and lymphocytic infiltration, leading to an SLE diagnosis confirmed by positive ANA, anti-dsDNA, and other antibodies. Treatment with methyprednisolone and azathioprine resulted in rapid symptom relief, and the patient remained asymptomatic at a 2-year follow-up. This case highlights the importance of considering SLE in patients with unexplained gastrointestinal symptoms and the effectiveness of immunosuppressive therapy in such cases.