Publikation

Successful treatment of gastrointestinal vasculitis due to systemic lupus erythematosus with intravenous pulse cyclophosphamide: a clinical case report and review of the literature

Wissenschaftlicher Artikel/Review - 01.09.1998

Bereiche
PubMed

Zitation
Grimbacher B, Huber M, von Kempis J, Kalden P, Uhl M, Köhler G, Blum H, Peter H. Successful treatment of gastrointestinal vasculitis due to systemic lupus erythematosus with intravenous pulse cyclophosphamide: a clinical case report and review of the literature. British journal of rheumatology 1998; 37:1023-8.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
British journal of rheumatology 1998; 37
Veröffentlichungsdatum
01.09.1998
ISSN (Druck)
0263-7103
Seiten
1023-8
Kurzbeschreibung/Zielsetzung

Gastrointestinal vasculitis in systemic lupus erythematosus (SLE) is quite rare and almost always accompanied by evidence of active disease in other organs, although occasionally it may be the presenting feature of the disease. Gastrointestinal involvement in SLE may present as lupus peritonitis, non-necrotizing pancreatitis, gastrointestinal vasculitis or surgical abdomen. Here we report a severe case of SLE which presented initially with fever of unknown origin. Severe distress, abdominal pain, the presence of occult blood in the stool and high acute-phase proteins were explained by a lupus peritonitis and intestinal vasculitis resembling inflammatory bowel disease. Whereas high-dose prednisone treatment did not prevent a severe relapse, we observed a sustained remission following i.v. cyclophosphamide pulse therapy. In the literature, only two similar cases are reported: one died despite a change in the therapy of a bowel perforation; our case was the second that improved under pulse cyclophosphamide. We suggest the use of cyclophosphamide after failure of steroids early in the course of SLE gastrointestinal vasculitis to prevent devastating complications.