Severe Lupus Enteritis Complicated by Intractable Gastrointestinal Hemorrhage

Authors

Austin Thomas
Clay Smithhart
Maneera Chopra
Athira Jayan
Faisal Ali
Karim Doughem
Asmeen Bhatt
Joanna Scoon
Scott Larson

Publication Date

11-1-2023

Journal

ACG Case Reports Journal

Abstract

Lupus enteritis (LE) is a rare presentation of systemic lupus erythematosus manifesting with nonspecific symptoms, laboratory derangements, and imaging findings. Rarely, LE may progress to bowel perforation, hemorrhage, and even death. Treatment with systemic glucocorticoids often results in rapid clinical improvement, but patients may require further immunosuppression. We present a case of severe LE complicated by life-threatening intractable gastrointestinal hemorrhage and warm autoimmune hemolytic anemia refractory to glucocorticoids and ultimately requiring massive transfusions, intravenous immunoglobulin, and plasmapheresis. This case illustrates the importance of early specialist involvement and treatment with intravenous immunoglobulin and plasmapheresis for severe, life-threatening LE.

Keywords

lupus enteritis, gastrointestinal hemorrhage, plasmapheresis, hemolytic anemia

Comments

PMID: 37928230