Acute Pancreatitis in the Systemic Lupus Erythematosus: A Case Series of Three Patients

Raouf Hajji^1, , Imed Ben Ghorbel², Mounir Lamloum², Amira Hamzaoui², Monia Khanfir² and Mohammed Habib Houman²

¹Internal Medicine Department, Sidi Bouzid Hospital, Ibn Aljazzar Medicine Faculty of Sousse, Tunisia

²Internal Medicine Department, La Rabta University Hospital, Medicine Faculty of Tunis, Tunisia

Cite this paper:
Raouf Hajji, Imed Ben Ghorbel, Mounir Lamloum, Amira Hamzaoui, Monia Khanfir and Mohammed Habib Houman. Acute Pancreatitis in the Systemic Lupus Erythematosus: A Case Series of Three Patients. American Journal of Medical Sciences and Medicine. 2015; 3(5):70-73. doi: 10.12691/ajmsm-3-5-3

Abstract

Background: Acute pancreatitis is a rare but life threatening complication of the systemic lupus erythematosus. We report three cases of lupus-associated pancreatitis. Case reports: Two women and one man with a mean age of 28 years presented with lupus pancreatitis. In our patients, it occurred after the lupus diagnosis with a delay average of 5.3 months. It is associated in these cases with other organ involvement. Clinical, biological and abdominal Computed tomography results confirm the diagnosis. The evolution after steroids and immunosuppressive is marked in all patients with good outcomes. Conclusion: Although it is a life threatening complication, acute pancreatitis in lupus can have good prognosis provided that early diagnosis and appropriate management based on corticosteroid therapy and symptomatic treatment were established.

Keywords:
systemic lupus erythematosus acute pancreatitis

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References:

[1]	Goel R, Subramanian R, Badika A, Sandhya P , Anoof PP, Surin A et al. Pancreatitis in systemic lupus erythematosus—case series over a period of three years from a tertiary care centre in South India. Indian J Rheumatol 2012; 5 (3): S 15.
[2]	Tian XP, Zhang X. Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment. World J Gastroenterol 2010; 16: 2971-7.
[3]	Moalla M, Boussen K, Meddeb S, Gorgi Y, Khalfallah T, Hentati F, et al. Pancréatite aiguë mortelle au cours d’un lupus érythémateux disséminé. Ann Med Interne 1991; 142: 230-2.
[4]	Wang F, Wang NS, Zhao BH, Tang LQ. Acute pancreatitis as an initial symptom of systemic lupus erythematosus: a case report and review of the literature. WorldJ Gastroenterol 2005; 11: 4766-8.
[5]	Breuer GS, Baer A, Dahan D, Nesher. Lupus associated pancreatitis. Autoimmun Rev 2006; 5: 314-8.
[6]	Nesher G, Breuer GS, Temprano K, Moore TL, Dahan D, Baer A, Alberton J, Izbicki G, Hersch M. Lupus-associated pancreatitis. Semin Arthritis Rheum 2006; 35: 260-7.
[7]	Hatron PY. Atteintes viscérales graves du lupus. Rev Prat 1998; 48: 620-5.
[8]	Hebbar M, Gosset D, Hatron PY, Devulder B. Pancréatite aiguë, lupus systémique et syndrome des anticorps antiphospholipides. Deux observations. Rev Méd Interne 1994; 15: 146-7.
[9]	Petri M. Pancreatitis in systemic lupus erythematosus: still in search of a mechanism. J Rheumatol 1992; 19: 1014-6.
[10]	Takasaki M, Yorimitsu Y, Takahashi I, Miyake S, Horimi T. Systemic lupus erythematosus presenting with drug-unrelated acute pancreatitis as an initial manifestation. Am J Gastroenterol 1995; 90: 1172-3.
[11]	Wang CR, Hsieh HC, Lee GL, Chuang CY, Chen CY. Pancreatitis related to antiphospholipid antibody syndrome in a patient with systemic lupus erythematosus. J Rheumatol 1992; 19: 1123-1125.
[12]	Lê Thi Huong D, Papo T, Laraki R, Wechsler B, Bletry O, Chapelon C, et al. Pancréatite au cours du lupus érythémateux disséminé. Revue de la littérature à propos de cinq observations. Rev Med Interne 1994;15:89-94.
[13]	Saab S, Corr MP, Weisman MH. Corticosteroids and systemic lupus erythematosus pancreatitis: a case series. J Rheumatol 1998; 25: 801-6.
[14]	Hebbar M, Gosset D, Hatron PY, Devulder B. Tuberculose pancréatique au cours d’un lupus systémique. Presse Méd 1994; 23:1179.
[15]	Ikura Y, Matsuo T, Ogami M, Yamazaki S, Okamura M,Yoshikawa J, et al. Cytomegalovirus associated pancreatitis in a patient with systemic lupus erythematosus. J Rheumatol 2000; 27:2715-7.
[16]	Sarles H, Sarles JC, Muratore R, Guien C. Chronic inflammatory sclerosis of the pancreas–an autonomous pancreatic disease? Am J Dig Dis. 1961; 6: 688-98.
[17]	Okazaki K, Uchida K, Matsushita M, Takaoka M. Autoimmune pancreatitis.Intern Med 2005; 44: 1215-22.
[18]	Members of the Criteria Committee for Autoimmune Pancreatitis of the Japan Pancreas Society. Diagnosis criteria for autoimmune pancreatitis by the Japan Pancreas Society. J Jpn Pancreas Soc 2002; 17: 587.
[19]	Kamisawa T, Funata N, Hayashi Y. Lymphoplasmacytic sclerosing pancreatitis is a pancreatic lesion of IgG4-related systemic disease. Am J Surg Pathol 2004; 28: 1114.