Protein-losing enteropathy as initial manifestation of systemic lupus erythematosus.

Abstract

Protein-losing enteropathy is a rare manifestation of systemic lupus erythematosus. We report the case of an 18-year-old woman that presented initially with diarrhoea and anasarca. During evaluation, there was low serum albumin of 1.6 g/dl (3.5-5.2 g/dl) and a positive antinuclear antibody test (1:2560). Anti-Sm antibodies (ELISA) were positive in addition to low serum C3 of 35 mg/dl. A scintigraphy using 99mTc-labelled albumin was positive for abdominal protein loss. A diagnosis of systemic lupus erythematosus related protein-losing enteropathy was made. She was started on prednisolone 40 mg/day without amelioration; a month later, azathioprine (100 mg/day) was added, leading to normalization of serum albumin and resolution of symptoms within 4 months. After 1.5 years, the patient developed a 2.9 g 24-h proteinuria while still in remission of the protein-losing enteropathy, receiving 5 mg prednisone and 100 mg azathioprine daily.

• Authors: F O A A Carneiro, L R Sampaio, L A R Brandão, L L B C Braga, F A C Rocha
• Journal: Lupus (Lupus) Vol. 21 Issue 4 Pg. 445-8 (Apr 2012) ISSN: 1477-0962 [Electronic] England
• PMID: 21997967 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Antinuclear
• Biomarkers
• Complement C3
• Immunosuppressive Agents
• Serum Albumin
• Prednisolone
• Azathioprine
• Prednisone

Topics

• Adolescent
• Antibodies, Antinuclear (blood)
• Azathioprine (therapeutic use)
• Biomarkers (blood)
• Complement C3 (analysis)
• Diarrhea (etiology)
• Drug Therapy, Combination
• Edema (etiology)
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Hypoalbuminemia (etiology)
• Immunosuppressive Agents (therapeutic use)
• Lupus Erythematosus, Systemic (blood, complications, diagnosis, drug therapy)
• Lupus Nephritis (etiology)
• Prednisolone (therapeutic use)
• Prednisone (therapeutic use)
• Protein-Losing Enteropathies (blood, diagnosis, drug therapy, etiology)
• Proteinuria (etiology)
• Serum Albumin (analysis)
• Time Factors
• Treatment Outcome