Language
English
Publication Date
6-1-2025
Journal
Lupus
DOI
10.1177/09612033251345020
PMID
40398633
PMCID
PMC12123055
PubMedCentral® Posted Date
5-21-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Objective
Systemic lupus erythematosus (SLE) is a complex autoimmune condition with diverse manifestations. Childhood-onset SLE (cSLE) presents more severely than adult-onset disease with a higher incidence of severe neurologic or renal manifestations and lower estimated survival rates. There is limited literature on the range of severe gastrointestinal manifestations at presentation in cSLE, and this lack of information results in underappreciation of these potentially life-threatening complications and little guidance regarding management of these patients.
Methods
We reviewed cases of patients with cSLE and severe GI manifestations at presentation diagnosed at our institution and additionally provide a comprehensive review of existing cases in the literature to discuss presenting symptoms, other clinical features, longitudinal course, treatment, and long-term outcomes.
Results
We identified six cases of cSLE with primary, severe GI symptoms at time of diagnosis at our institution and an additional 25 patients who presented similarly in the literature. Severe GI manifestations included protein-losing enteropathy, thoracoabdominal aortitis, severe pancreatitis, lupus enteritis or mesenteric vasculitis, and intestinal pseudo-obstruction. Delays in diagnosis affected several patients, and 26% of patients required surgical intervention. Many patients required intensive immunomodulatory treatment in addition to prolonged bowel rest and parenteral nutrition. Long-term outcomes of GI manifestations varied overall, however, most patients at our institution achieved clinical remission.
Conclusions
Understanding these rare cases of severe GI manifestations in cSLE can aid clinicians in prompt diagnosis and collaborative management, improving clinical outcomes for this vulnerable population.
Keywords
Humans, Lupus Erythematosus, Systemic, Female, Male, Child, Gastrointestinal Diseases, Adolescent, Age of Onset, Severity of Illness Index, Protein-Losing Enteropathies, Intestinal Pseudo-Obstruction, Pancreatitis, Protein-losing enteropathy, thoracoabdominal aortitis, pancreatitis, enteritis, intestinal pseudo-obstruction
Published Open-Access
yes
Recommended Citation
Orozco, James; Nguyen, Jessica; Yasrebi, Sara Mm; et al., "Severe Gastrointestinal Manifestations in Childhood-Onset Lupus: A Single-Center Cohort and Review of the Literature" (2025). Faculty and Staff Publications. 5809.
https://digitalcommons.library.tmc.edu/baylor_docs/5809