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SLE罕见的首发表现——肠系膜血管炎

2021-11-20 郑医生 风湿免疫科郑医生

系统性红斑狼疮狼疮肠系膜血管炎
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狼疮肠系膜血管炎是引起SLE患者腹痛的重要原因，又称狼疮性肠炎，由Hoffman和Katz于1980年首次描述。SLE胃肠道表现的其他并发症包括蛋白缺失性肠病、肠假性梗阻、肝脏受累、肠坏疽和胰腺炎。

系统性红斑狼疮（SLE）是一种多系统自身免疫性疾病，可影响胃肠道（gastrointestinal tract，GIT）。GIT相关症状在SLE患者中很常见，发生率高达40%-50%，几乎累及GIT相关的任何器官。腹痛是SLE最常见的症状，约占75%。
狼疮肠系膜血管炎（lupus mesenteric vasculitis，LMV）是引起SLE患者腹痛的重要原因，又称狼疮性肠炎，由Hoffman和Katz于1980年首次描述。
LMV是SLE的一种非常罕见的表现，在活动期患者中发生率为0.2%-9.7%，在非活动期患者中发生率＜1%，但它是SLE最严重的并发症之一，死亡率高。在某些情况下，LMV可先于SLE的典型临床表现出现。
就LMV患者累及的器官而言，最近的一项研究发现，83%的病例累及空肠，84%的病例累及回肠，19%的病例累及结肠，17%的病例累及十二指肠，4%的患者累及直肠。SLE胃肠道表现的其他并发症包括蛋白缺失性肠病、肠假性梗阻、肝脏受累、肠坏疽和胰腺炎。此外，作为一种罕见的成人诊断，肠套叠也会被报道为最初的症状。
下面分享一个关于LMV的病例。

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参考文献：Alshehri AM, Alhumaidi HM, Asseri YM, Ahmed ME, Omer HA. Mesenteric vasculitis as a rare initial presentation of systemic lupus erythematosus: A case report. Saudi J Med Med Sci

2020;8:223-6.

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    2021-11-21 shijzhiewnjhch

    #血管炎#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1263266, encodeId=7564126326629, content=<a href='/topic/show?id=581e8968859' target=_blank style='color:#2F92EE;'>#血管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89688, encryptionId=581e8968859, topicName=血管炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=909c71, createdName=shijzhiewnjhch, createdTime=Sun Nov 21 02:10:40 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345055, encodeId=09c1134505503, content=<a href='/topic/show?id=cf721640495' target=_blank style='color:#2F92EE;'>#SLE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16404, encryptionId=cf721640495, topicName=SLE)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/kbRUeosenzlejlNGWXdWjSYhBKL1QYGQwfehJOkMXHiavh5wl7pKeju5Kcxdvr50ic6FWML3x6NMCxhG1bOaVjyA/132, createdBy=20872500216, createdName=ms4657536712156177, createdTime=Sun Nov 21 02:10:40 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1467637, encodeId=4a6d146e637ac, content=<a href='/topic/show?id=ef32e9539e8' target=_blank style='color:#2F92EE;'>#罕见#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79539, encryptionId=ef32e9539e8, topicName=罕见)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=29f36868190, createdName=syscxl, createdTime=Sun Nov 21 02:10:40 CST 2021, time=2021-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557272, encodeId=7da5155e2724b, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Sun Nov 21 02:10:40 CST 2021, time=2021-11-21, status=1, ipAttribution=)]
    2021-11-21 ms4657536712156177

    #SLE#

    0

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    2021-11-21 syscxl

    #罕见#

    0

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    2021-11-21 zzc2216

    #肠系膜#

    0

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