Intestinal pseudo-obstruction and ureterohydronephrosis in systemic lupus erythematosus / 中华风湿病学杂志

ABSTRACT

Objective To enhance the understanding of systemic lupus erythematosus (SLE) associated with intestinal pseudo-obstruction (IPO) and ureterohydronephrosis. Methods Ten cases of SLE with IPO and ureterohydronephrosis were analyzed retrospectively. Results IPO was the initial manifestation of SLE in three patients. Seven cases (7/9) had concurrent bilateral ureterohydronephrosis, 5 (5/9) had thickened bladder wall, and 6 cases (6/8) were associated with thickened gallbladder wall simultaneously. All cases were ANA positive and hypocomplementemia, 6 had positive anti-dsDNA, 5 had positive anti-SSA, 6 had positive anti-RNP, and 4 were ACA-IgG positive (4/7). IPO responded readily to high dose steroid therapy within one week in all patients. Conclusions The pathogenic mechanism of IPO is not fully understood. The coexistence of IPO, ureterohydronephrosis and thickened gallbladder wall probably suggests a visceral smooth muscle dysmotility. Early recognition of the syndrome is necessary for the initiation of the appropriate medical treatment and prevention of inappropriate surgical intervention.