Mesenteric Arteritis with Perforation of the Jejunum in a Patient with Systemic Lupus Erythematosus

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SYSTEMIC lupus erythematosus (SLE) is frequently accompanied by gastrointestinal symptoms. Occasionally the first symptoms of lupus erythematosus (LE) comprise the clinical picture of acute abdominal pain which complicates the diagnosis. In gastrointestinal LE, the basic pathologic condition has been a peritonitis, pancreatitis, or arteritis involving various-sized mesenteric vessels, each of which disorder usually responds to steroid therapy.

Our report concerns a patient in whom, during an exacerbation of SLE, the clinical picture of an acute condition of the abdomen developed, and who was thought to have acute pancreatitis. Subsequently, mesenteric arteritis and perforation of a segment of the jejunum required surgical treatment. This case report is one of few published reports of arteritic perforation of the intestine in association with systemic lupus erythematosus.

Report of a Case

A 38-year-old white man on August 9, 1961, was transferred to the Cleveland Clinic Hospital from a hospital in Maine, because of acute abdominal pain, and with a diagnosis of acute pancreatitis. Nearly 10 years previously, in October, 1951, a diagnosis of SLE was made, and at that time he had a history of migratory polyarthritis for 9 months, an intermittent low-grade fever, three bouts of deep thrombophlebitis of the left calf, a livid discoloration of the malar eminences after exposure to sunlight, a rash on the hands, and one bout of bilateral pleural effusion. He had had several positive LE tests at that time.

During the next nine years, he had many recurrences of LE symptoms, including Raynaud’s phenomenon, diplopia and blurred. . .



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