Systemic lupus erythematosus gastrointestinal involvement: a computed tomography-based assessment

Zhiwei Chen,Xiaodong Wang,Shuhui Sun,Ting Li,Wenwen Xu,Jiaoyu Li,Liyang Gu,Shuang Ye,Fangfang Sun,Yiquan Zhou,Liangjing Lu,Jie Chen,Yan Zhao,Wanlong Wu,Wen Zhang,Jiaxin Zhou,Jiajie Li

doi:10.1038/s41598-020-63476-9

Abstract

Systemic lupus erythematosus (SLE) gastrointestinal (GI) complication is characterized by multi-segment and multi-compartment involvement. The aim of this study is to develop a computed tomography (CT) image-based system for disease evaluation. SLE patients with GI involvement from two independent cohorts were retrospectively included. Baseline abdominal CT scan with intravenous and oral contrast was obtained from each individual. A CT scoring system incorporating the extent of GI tract involvement and intestinal wall thickness, along with extra-GI compartment involvement, was developed and validated. The outcome measurement was the time to GI functional recovery, defined as the time to tolerable per os (PO) intake ≥50% of ideal calories (PO50). A total of 54 and 37 patients with SLE GI involvement were enrolled in the derivation and validation cohorts, respectively. The CT scores for SLE GI involvement were positively correlated with patients’ time to PO50 (r = 0.57, p < 0.0001, derivation cohort; r = 0.42, p = 0.0093, validation cohort). Patients with a CT score ≤ 3 had a shorter time to PO50 (median time of 0 day) in pooled cohort, whereas those with a CT score > 3 incurred a significantly prolonged recovery with a median time to PO50 of 13 days (p < 0.0001). The CT-based scoring system may facilitate more accurate assessment and individualized management of SLE patients with GI involvement.

Highlights

Systemic lupus erythematosus (SLE) gastrointestinal (GI) complication is characterized by multisegment and multi-compartment involvement
It is noteworthy that computed tomography (CT) imaging has been well accepted in the evaluation of SLE GI involvement
We are aiming to focus on the second question, i.e., to develop a CT image-based evaluation system for SLE GI involvement in order to more precisely measuring the extent and severity of the disease, which hopefully, might pave the path leading to better understanding and controlling this disease

Summary

Introduction

Systemic lupus erythematosus (SLE) gastrointestinal (GI) complication is characterized by multisegment and multi-compartment involvement. The aim of this study is to develop a computed tomography (CT) image-based system for disease evaluation. A CT scoring system incorporating the extent of GI tract involvement and intestinal wall thickness, along with extra-GI compartment involvement, was developed and validated. A total of 54 and 37 patients with SLE GI involvement were enrolled in the derivation and validation cohorts, respectively. The CTbased scoring system may facilitate more accurate assessment and individualized management of SLE patients with GI involvement. We are aiming to focus on the second question, i.e., to develop a CT image-based evaluation system for SLE GI involvement in order to more precisely measuring the extent and severity of the disease, which hopefully, might pave the path leading to better understanding and controlling this disease

Objectives

Methods

Results

Conclusion