Authors
Nozomi Kawamata, Hidetoshi Kawana, Masatoshi Usui, Ayaka Ota, Hayato Nakazawa, Shinnichi Tazawa, Hideyuki Takasiro, Katsunobu Tawada, Hirofumi Saito, Hiromasa Nomoto
Published in
Clinical journal of gastroenterology. Nov 06, 2026. Epub Nov 06, 2026.
Abstract
Lupus enteritis may precede recognition of systemic lupus erythematosus. A 40 year-old woman experienced self-limiting episodes of abdominal pain, nausea, vomiting, and diarrhea in April and May 2026. Upper gastrointestinal endoscopy in May, as symptoms were subsiding, showed no significant abnormalities; colonoscopy with rectal biopsy was nondiagnostic. In July, recurrent symptoms prompted admission. C-reactive protein was 0.16 mg/dL despite extensive small-bowel wall edema, mesenteric vessel engorgement, ascites, and bilateral urinary tract dilatation without mechanical obstruction on computed tomography. Routine stool culture and Clostridioides difficile toxin testing and culture were negative. High-titer antinuclear antibodies, anti-Sm antibodies, hypocomplementemia, and leukopenia supported a new diagnosis of systemic lupus erythematosus. The integrated findings favored lupus enteritis with suspected lupus-associated urinary tract involvement. Prednisolone treatment was followed by clinical and radiological improvement. At approximately 12 weeks, there was no clinical relapse, and prednisolone had been tapered to 15 mg/day. This case illustrates how recurrent apparently self-limiting gastrointestinal episodes, nondiagnostic interval endoscopy, a minimal C-reactive protein response despite extensive imaging abnormalities, and unexplained urinary tract dilatation can together prompt recognition of previously undiagnosed systemic lupus erythematosus.
PMID:
42993467
Bibliographic data and abstract were imported from PubMed on 07 Nov 2026.
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