Clinical and Abdominal Computerized Tomography Characteristics of Patients with Image-Defined Lupus Mesenteric Vasculitis

Abstract

Objective: Lupus mesenteric vasculitis (LMV) is a rare but challenging diagnostic issue related to patients with systemic lupus erythematosus (SLE). Early recognition by means of clinical signs, laboratory parameters and abdominal computerized tomography (CT) can help in differential diagnosis. The aim of this study was to describe the clinical characteristics, images features and discover possible risk factors of patients with LMV.Methods: Seventeen patients with history of SLE at Kaohsiung Chang Gung Memorial Hospital from 2004 to 2012 were identified according to clinical symptoms and fulfilling at least three of the following signs on abdominal CT scan: bowel wall thickening, bowel distention, target sign, comb sign, and fat attenuation. We recorded the clinical symptoms, laboratory data, and compared with 22 control lupus patients who experienced abdominal pain but LMV was excluded after abdominal CT survey.Results: The most frequent clinical symptoms of the 17 patients were abdominal pain, nausea/vomiting, and diarrhea. The abdominal CT findings were mainly bowel wall thickening, bowel distention and the comb sign. There were no significant differences between baseline and LMV onset in the hemogram, C-reactive protein, complement, and anti-double stranded DNA antibody. Patients with positive anti-β2 glycoprotein I antibody had a greater tendency to develop LMV than the control group (OR = 6.33, 95% CI = 1.06-37.78, p=0.04).Conclusions: We identified the frequent clinical symptoms and abdominal CT features present in patients with LMV. Of all the laboratory parameters and serologic markers, anti-β2 glycoprotein I antibody was found to be a risk factor that is associated with LMV.