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SAT0013 Lupus Enteritis: Clinical Characteristics and Risk Factors Associated with Recurrence
  1. B.S. Koo1,
  2. Y.J. Kim1,
  3. J.S. Oh2,
  4. S. Hong1,
  5. W.J. Seo3,
  6. Y.-G. Kim1,
  7. C.-K. Lee1,
  8. B. Yoo1
  1. 1Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul
  2. 2Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan
  3. 3Division of Rheumatology, Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea, Republic Of

Abstract

Background Lupus enteritis is a severe complication of systemic lupus erythematosus (SLE) cases with acute abdominal pain. Some studies have identified clinical characteristics and risk factors for relapse in lupus enteritis 1–4. However, no prognostic indicators of this disease have been described clearly to date.

Objectives To compare the clinical characteristics of lupus enteritis and non-lupus enteritis patients with SLE and identify predictors of recurrence of lupus enteritis.

Methods We retrospectively reviewed the medical records of 62 patients in our hospital who underwent an abdominal computer tomography (CT) scan between January 1997 and December 2013 for suspected lupus enteritis. CT scan findings including bowel wall edema, abdominal bowel-wall enhancement, and dilatation of the bowel lumen were used to confirm the diagnosis. We compared the clinical characteristics, laboratory data, and CT findings between lupus enteritis and non-lupus enteritis patients.

Results Of our 62 SLE patients with enteric symptoms, the CT scan of 46 cases (68%) was compatible with lupus enteritis. The lupus enteritis cases showed a lower level of C4 than the non-lupus enteritis group (9.0±5.6 vs. 12.3±6.2, p=0.032). Recurrence of lupus enteritis was observed in 14 patients (28%) with a median number of 2.5 episodes (range, 1-8). Recurrent cases showed more colon (78% vs. 40%, p=0.026) and urinary tract (57% vs. 25%, p=0.048) involvement than the non-recurrent group. The hemoglobin and albumin levels were significantly higher in recurrent patients (p=0.013, p=0.023). The adjusted hazard ratio (HR) of variables associated with recurrence were 4.689 for colon involvement (95% confidence interval (CI): 1.245-17.659, p=0.0220, 5.468 for urinary tract involvement was (95% CI: 1.629-18.360, p=0.006), and 1.329 for hemoglobin (95% CI: 1.034-1.707, p=0.026).

Conclusions A low C4 is helpful in diagnosing lupus enteritis. Colon and urinary tract involvement is associated with the recurrence of lupus enteritis.

References

  1. Janssens P, Arnaud L, Galicier L, et al. Lupus enteritis: from clinical findings to therapeutic management. Orphanet J Rare Dis 2013;8:67.

  2. Kim YG, Ha HK, Nah SS, et al. Acute abdominal pain in systemic lupus erythematosus: factors contributing to recurrence of lupus enteritis. Ann Rheum Dis 2006;65:1537-8.

  3. Kwok SK, Seo SH, Ju JH, et al. Lupus enteritis: clinical characteristics, risk factor for relapse and association with anti-endothelial cell antibody. Lupus 2007;16:803-9.

  4. Yuan S, Ye Y, Chen D, et al. Lupus mesenteric vasculitis: Clinical features and associated factors for the recurrence and prognosis of disease. Semin Arthritis Rheum 2013.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2797

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