Document Detail


Lupus mesenteric vasculitis can cause acute abdominal pain in patients with SLE.
MedLine Citation:
PMID:  19412194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lupus mesenteric vasculitis (LMV) is a unique clinical entity found in patients who present with gastrointestinal manifestations of systemic lupus erythematosus, and is the main cause of acute abdominal pain in these patients. LMV usually presents as acute abdominal pain with sudden onset, severe intensity and diffuse localization. Other causes of abdominal pain, such as acute gastroenteritis, peptic ulcers, acute pancreatitis, peritonitis, and other reasons for abdominal surgery should be ruled out. Prompt and accurate diagnosis of LMV is critical to ensure implementation of appropriate immunosuppressive therapy and avoidance of unnecessary surgical intervention. The pathology of LMV comprises immune-complex deposition and complement activation, with subsequent submucosal edema, leukocytoclastic vasculitis and thrombus formation; most of these changes are confined to small mesenteric vessels. Abdominal CT is the most useful tool for diagnosing LMV, which is characterized by the presence of target signs, comb signs, and other associated findings. The presence of autoantibodies against phospholipids and endothelial cells might provide information about the likelihood of recurrence of LMV. Immediate, high-dose, intravenous steroid therapy can lead to a favorable outcome and prevent serious complications such as bowel ischemia, necrosis and perforation.
Authors:
Ji Hyeon Ju; Jun-Ki Min; Chan-Kwon Jung; Soon Nam Oh; Seung-Ki Kwok; Kwi Young Kang; Kyung-Su Park; Hyuk-Jae Ko; Chong-Hyeon Yoon; Sung-Hwan Park; Chul-Soo Cho; Ho-Youn Kim
Related Documents :
18407804 - Diagnostic laparoscopy for chronic abdominal pain after gastric bypass.
3121864 - Jejunal distention with elemental feedings following duodenal injury.
17406914 - Renal medullary carcinoma: unsuspected diagnosis at stone protocol ct.
16363294 - Human fascioliasis among immigrant workers in saudi arabia.
9185434 - Cost-effectiveness analysis of spinal cord stimulation in treatment of failed back surg...
20831684 - Case report. intravenous fentanyl patient-controlled analgesia for perioperative treatm...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Nature reviews. Rheumatology     Volume:  5     ISSN:  1759-4804     ISO Abbreviation:  Nat Rev Rheumatol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-04     Completed Date:  2009-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101500080     Medline TA:  Nat Rev Rheumatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  273-81     Citation Subset:  IM    
Affiliation:
Rheumatology Division, College of Medicine, Catholic University of Korea, Seocho-Gu, Seoul, South Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / diagnosis,  etiology*,  physiopathology
Acute Disease
Autoantibodies / blood
Complement Activation
Diagnosis, Differential
Gastroenteritis / diagnosis
Humans
Immune Complex Diseases / etiology,  pathology
Lupus Erythematosus, Systemic / complications*,  diagnosis,  physiopathology
Mesenteric Arteries / pathology,  radiography
Mesenteric Veins / pathology,  radiography
Mesentery / blood supply
Pancreatitis / diagnosis
Peptic Ulcer / diagnosis
Peritonitis / diagnosis
Radiography, Abdominal
Vasculitis / diagnosis,  etiology*,  physiopathology
Chemical
Reg. No./Substance:
0/Autoantibodies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Epigenetic control in rheumatoid arthritis synovial fibroblasts.
Next Document:  Rapidly fatal HTLV-1-associated T-cell leukemia/lymphoma in a patient with SLE.