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http://dx.doi.org/10.3904/kjm.2012.82.2.252

A Case of Systemic Lupus Erythematosus Presenting as a Large Rectosigmoid Ulcer  

Yoo, In-Kyung (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Yoo, Seu-Hee (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Choi, Sung-Jae (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Koo, Ja-Seol (Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Lee, Young-Ho (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Ji, Jong-Dae (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Song, Kwan-Kyu (Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.82, no.2, 2012 , pp. 252-256 More about this Journal
Abstract
Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder that has many symptoms. Gastrointestinal symptoms are common, while colonic involvement in the form of ischemic colitis or a colonic ulcer is rare in SLE. The differential diagnosis of ischemic proctitis with ulceration includes an infected ulcer, ulcerative colitis, Crohn's disease, solitary rectal ulcer colitis, malignant tumor, and lupus colitis. Here, we report a 22-year-old male with abdominal pain and diarrhea, who had a huge rectal ulcer that nearly obstructed the rectosigmoid junction. This turned out to be a rare gastrointestinal manifestation of lupus. He recovered after being treated with high-dose oral steroids. Our case demonstrates that a rectal ulcer is a rare, but important, complication of SLE and can be the initial clinical manifestation of the disease.
Keywords
Systemic lupus erythematosus; Proctitis; Ischemic colitis;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Kim DH, Na HJ, Choi YR, et al. A case of extensive involvement of lupus enteritis, from small bowel to rectum. J Korean Rheum Assoc 2007;14:274-278.   DOI
2 Chattopadhyay P, Abby Philips C, Dhua D, Saha S. Systemic lupus erythematosus presenting as ischaemic proctitis. Lupus 2011;20:653-655.   DOI
3 Ju JH, Min JK, Jung CK, et al. Lupus mesenteric vasculitis can cause acute abdominal pain in patients with SLE. Nat Rev Rheumatol 2009;5:273-281.   DOI
4 Ahn JK. Clinical manifestations and diagnosis of systemic lupus erythematosus. Korean J Med 2010;78:409-415.
5 Juvonen T, Niemela O, Reinila A, Nissinen J, Kairaluoma MI. Spontaneous intraabdominal haemorrhage caused by segmental mediolytic arteritis in a patient with systemic lupus erythematosus: an underestimated entity of autoimmune origin? Eur J Vasc Surg 1994;8:96-100.   DOI
6 Sultan SM, Ioannou Y, Isenberg DA. A review of gastrointestinal manifestations of systemic lupus erythematosus. Rheumatology (Oxford) 1999;38:917-932.   DOI
7 Lee KA, Bae SC, Bang SY, et al. A case of systemic lupus erythematosus patient with ulcerative colitis. J Korean Rheum Assoc 2008;15:328-331.   DOI
8 Lee JR, Paik CN, Kim JD, Chung WC, Lee KM, Yang JM. Ischemic colitis associated with intestinal vasculitis: histological proof in systemic lupus erythematosus. World J Gastroenterol 2008;14:3591-3593.   DOI
9 Hiraishi H, Konishi T, Ota S, Shimada T, Terano A, Sugimoto T. Massive gastrointestinal hemorrhage in systemic lupus erythematosus: successful treatment with corticosteroid pulse therapy. Am J Gastroenterol 1999;94:3349-3353.   DOI