Vomiting and diarrhea in a woman with systemic lupus erythematosus

Lupus mesenteric enteritis is an uncommon condition in systemic lupus erythematosus (SLE) patients with acute abdominal pain. We describe a 28-year-old woman with a 3-day history of watery diarrhea and intermittent vomiting. Abdominal ultrasonography revealed thickening of the intestinal wall and edema with the lumen filled with fluid in this patient with nonspecific symptoms. These ultrasonographic findings led the physician to perform an abdominal computed tomography (CT) scan, which revealed typical findings of lupus mesenteric enteritis: intestinal wall thickening with target signs and prominent engorgement of mesenteric vessels with a palisade pattern. After high dose methylprednisolone (1 g/day intravenously) was administered for 3 days, the patient's symptoms markedly improved. Additionally, resolution of the mural thickening was observed within 1 week by abdominal ultrasound examinations. Our experience indicated that abdominal ultrasonography can be important in the correct diagnosis of lupus mesenteric vasculitis (LMV). Copyright (C) 2014 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.