以消化系症状为首发表现的系统性红斑狼疮1例

Systemic lupus erythematosus with gastrointestinal symptoms as the first manifestation:A case report

系统性红斑狼疮累及消化系的报道较少,而以消化系症状为首发表现的报道更是少见.现报道以消化系症状为首发表现且病程中出现假性肠梗阻的系统性红斑狼疮1例;患者,女,28岁,因"腹痛、呕吐、腹泻"1mo余入院,腹部CT检查示肠梗阻、腹水及肠壁明显水肿、增厚并分层强化呈环形的"靶征"、"双轨征"及"梳状征";实验室检查IgA、IgG升高,补体C3、C4下降,抗nRNP/Sm抗体、抗Sm抗体、抗SS-A抗体、抗核抗体均阳性,病程中出现泌尿系统受累表现;经糖皮质激素及环磷酰胺治疗后病情缓解.

Systemic lupus erythematosus（SLE） presenting with gastrointestinal symptoms is rare,and SLE with gastrointestinal symptoms as the first manifestation is an even rarer condition.Here we report a case of SLE with gastrointestinal symptoms as the first manifestation in a 28-years-old woman.She developed abdominal pain,diarrhea,nausea and vomiting about a month ago.An abdominal CT scan demonstrated intestinal obstruction,ascites and marked edematous thickening of the bowel wall,which appeared as ＂target sign＂,＂double-track sign＂ and ＂comblike sign＂.Laboratory tests showed that her serum complement levels decreased and that she was positive for anti-nRNP/Sm antibodies,antiSm antibodies,anti-SS-A antibody,and antinuclear antibodies.Treatmen consisting of high dose glucocorticoids and cyclophosphamide led to rapid remission of both digestive tract and urinary tract symptoms.