Pancreatic pseudocyst as initial presentation of a 22-year-old male lupus patient

Abstract

Systemic Lupus Erythematosus (SLE) related acute pancreatitis is an unusual feature of SLE that lead to serious complication like pancreatic pseudocyst. Acute pancreatitis or pancreatic pseudocyst as the initial presentation of SLE is rarely been reported. A 22-year-old gentleman presented with fever, abdominal pain with distension and facial puffiness. Examination revealed anaemia, Alopecia, tachycardia, oedema, Blood pressure of 110/70 mm of Hg, abdominal tenderness, abdominal distension and crackles. Urine examination showed active sediments with proteinuria of 3.8g/day. ANA and Ani-dsDNA were positive. Serum amylase and Lipase were 192U/L and 658U/L respectively. A computed tomography scan showed a Pancreatic pseudocyst of size 55 42 38 mm. Kidney biopsy revealed diffuse proliferative glomerulonephritis with full house immune complexes. Follow-up ultrasonography showed resolution of Pseudocyst. Conclusion: High index of suspicion is required to diagnose SLE related pancreatitis as presenting features of SLE may mask it. This might ensure early diagnosis and treatment to prevent complications of the disease.