The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Case Report: A Lupus Patient with Abdominal Pain

Case Report: A Lupus Patient with Abdominal Pain

February 16, 2021 • By Emily Purcell, MD, Colin Ligon, MD, MHS, & Chris T. Derk, MD, MS

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Figure 1: Computed Tomography of the Abdomen

Figure 1: Computed Tomography of the Abdomen

Our patient was a 33-year-old, 5’2″ Asian woman with a past medical history of systemic lupus erythematosus (SLE). The diagnosis was based on serologies positive for anti-nuclear antibodies (ANAs), as well as antibodies to Sm, RNP and SSA. Her illness included neuropsychiatric and cutaneous involvement. She also had a diagnosis of Hashimoto’s thyroiditis. 

You Might Also Like
  • Rheumatology Case Report: Bullous Lesions in Patient with Lupus
  • Case Report: Drug-Induced Lupus & ANCA-Associated Vasculitis Overlap
  • Case Report: Evans Syndrome in Lupus
Explore This Issue
February 2021

She presented with two weeks of abdominal bloating and one week of abdominal pain, nausea, vomiting and non-bloody diarrhea. Her symptoms began two weeks before, with abdominal fullness and bloating, which progressed to acute-onset, diffuse, intermittent, cramping abdominal pain associated with non-bloody emesis and multiple episodes of non-bloody, watery diarrhea. She had not been able to tolerate oral intake for the past few days. She denied fevers, chills, sick contacts or recent travel, but said a sweet potato casserole she ate may have been “bad.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

One week prior to admission, she was seen in student health and was given intravenous fluids and antiemetics. A few days prior to admission, she presented to the emergency department for persistent symptoms. An abdominal ultrasound done in the emergency department was unremarkable, a pregnancy test was negative, and enteric stool pathogen testing was negative. She improved after receiving intravenous fluids and antiemetics and was again sent home. 

The patient felt better for one or two days and was able to eat and drink, but then her symptoms returned—this time with more severe abdominal pain and bloating—and she returned to the emergency department.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

On further questioning, she reported a similar episode occurred about 11 months before. That episode lasted for a few days and resolved after she was administered intravenous fluids at student health.

Lupus History

Figure 2: Radiograph of the Chest

Figure 2: Radiograph of the Chest

Our patient was first diagnosed with SLE in 2014. She had acute cutaneous lupus, with biopsy-proven interface dermatitis (i.e., a pattern of skin reaction characterized by an inflammatory infiltrate that appears to obscure the dermo-epidermal junction when observed at low-power examination and referred to as lichenoid tissue reaction) and was initiated on 200 mg of hydroxychloroquine twice a day.

In 2015, she developed neuropsychiatric symptoms—seizures with an elevated immunoglobulin G (IgG) index on her cerebrospinal fluid analysis—as well as oral ulcers and alopecia. Serologies at that time were remarkable for an ANA of 1:1280 in a speckled pattern, anti-Sm, anti-RNP and anti-SSA antibodies, low complements and leukopenia. 

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

She was treated with 1,000 mg of intravenous methylprednisolone daily for three days. Her treatment also included 1,500 mg of mycophenolate mofetil twice a day, 200 mg of hydroxychloroquine twice a day and a slow taper of prednisone. 

She self-discontinued all of her medications toward the later part of 2015 due to what she described as medication side effects and a concern for toxicity. 

Pages: 1 2 3 4 5 | Single Page

Filed Under: Conditions, SLE (Lupus) Tagged With: abdominal pain, case report, gastrointestinal, lupus enteritis, SLE Resource CenterIssue: February 2021

You Might Also Like:
  • Rheumatology Case Report: Bullous Lesions in Patient with Lupus
  • Case Report: Drug-Induced Lupus & ANCA-Associated Vasculitis Overlap
  • Case Report: Evans Syndrome in Lupus
  • Case Study: Cerebral Toxoplasmosis in a Newly Diagnosed Lupus Patient

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)