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증 례 : 범발성 장염 소견으로 진단된 전신 홍반 루푸스
이한아 ( Han Ah Lee ),심혜기 ( Hye Gi Shim ),서영호 ( Young Ho Seo ),최성재 ( Sung Jae Choi ),이범재 ( Beom Jae Lee ),이영호 ( Young Ho Lee ),지종대 ( Jong Dae Ji ),김재훈 ( Jae Hoon Kim ),송관규 ( Gwan Gyu Song ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.2
Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE), needing prompt diagnosis and proper management. However, SLE rarely presents as lupus enteritis at the time of initial diagnosis. Thus, delayed diagnosis and misdiagnosis are common. We report a case of a 25-year-old woman with lupus panenteritis. The patient had multiple hospitalizations for abdominal pain, nausea, and diarrhea, initially without any other symptoms suggestive of SLE, but was later observed to have malar rash and oral ulcers. Laboratory investigations were compatible with SLE, including positive antinuclear antibody (1:320) with speckled pattern. CT revealed diffuse hypodense submucosal thickening of the stomach, the entire small bowel, colon, appendix, and rectum. Treatment with high-dose corticosteroids followed by maintenance therapy with mycophenolate mofetil, hydroxychloroquine, and azathioprine resulted in clinical improvement. Diagnosis of lupus enteritis requires a high index of suspicion given the low incidence and nonspecific clinical findings.