Abstract
Introduction: Gastrointestinal symptoms are common in systemic lupus erythematosus (SLE) and are often difficult to interpret. Specific lupus involvement (lupus enteritis) typically affects the jejunum and ileum, whereas colonic and rectal involvement remains rare. Lymphocytic colitis (LC) associated with SLE remains exceptional and unusual. We report an original observation of LC occurring in a 35-year-old patient with SLE. Case report: 35-year-old woman, having in her medical history a Hashimoto thyroiditis diagnosed for four years and a SLE diagnosed for three years, consulted for chronic fluid diarrhea, not improved by symptomatic treatment, and associated for two weeks with rectorrhagia. Somatic examination, basic biological tests, stool culture and parasitological stool examination were without abnormalities. Colonoscopy revealed a diffuse minimal inflammatory colitis interesting the entire colon, and the pathological examination of multiple biopsies led to the diagnosis of isolated LC. She was treated with 5-amino-salicylate with good evolution. Conclusion: Our observation is, to our knowledge the third reporting the association of LC with SLE; it is characterized in addition by the young age of occurrence. This association once again comforts the hypothesis of a common pathophysiology to these two diseases mainly involving genetic predisposition, HLA susceptibility, immune disorders, and environmental factors.
Highlights
Gastrointestinal symptoms are common in systemic lupus erythematosus (SLE) [1] and are often difficult to interpret: specific lesion of lupus? Infectious complication? Adverse effect of treatment? Or association with other dysimmune diseases? [1,2]
We report an original observation of Lymphocytic colitis (LC) occurring in a 35-year-old lupus patient
35-year-old woman, having in her medical history a Hashimoto thyroiditis diagnosed for four years and a SLE diagnosed for three years
Summary
Gastrointestinal symptoms are common in systemic lupus erythematosus (SLE) [1] and are often difficult to interpret: specific lesion of lupus? Infectious complication? Adverse effect of treatment? Or association with other dysimmune diseases? [1,2]. Gastrointestinal manifestations can be objectified in up to 50% of Lupus patients [3]; Specific lupus involvement (lupus enteritis, described for the first time in 1980 by Hoffman BI and Katz WA [4]), remains exceptional and unusual [5]. It typically affects the jejunum and ileum, whereas colonic and rectal involvement remains rare [5,6]. The mechanism involved is usually gastrointestinal vasculitis and/or gastrointestinal microthromboses, if associated antiphospholipid antibody syndrome [7,8]. We report an original observation of LC occurring in a 35-year-old lupus patient
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