BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment o...BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.展开更多
Background： The incidence of atherosclerosis-related myocardial infarction can be as much as 50-fold greater in young patients with systemic lupus e~,thematosus （SLE） than in age-matched controls. There are several...Background： The incidence of atherosclerosis-related myocardial infarction can be as much as 50-fold greater in young patients with systemic lupus e~,thematosus （SLE） than in age-matched controls. There are several explanations for this phenomenon, all of which result in a chronic state of low-grade inflammation. Recently, the neutrophil-to-lynlphocyte ratio （NLR） has been proposed as a useliil biomarker of inflammation. Pulse wave velocity （PWV） is a reliable indicator of vascular damage and atherosclerosis. There is a paucity of data concerning the relationship between NLR and atherosclerosis as measured by PWV in patients with SLE. This study aimed to verify whether there is a positive correlation between NLR and PWV and to explore factors that influence PWV in young SLE patients. Methods： A total of 90 female patients with SLE were enrolled in this cross-sectional investigation. Traditional and nontraditional cardiovascular risk factors were assessed on the same day that brachial-ankle PWV （baPWV） was examined. The patients were divided into three groups according to their mean baPWV values： patients whose mean baPWV value was lower than the first tertile were placed in Group 1 ： patients whose mean baPWV value was between the first tertile and the second tertile were placed in Group 2： and patients whose mean baPWV value was higher than the second tertile were placed in Group 3. SPSS 20.0 was used to perform all statistical analyses in this study. Both univariate linear regression and multivariate regression models were utilized to analyze the association between NLR and arterial stiffness. Results： Systolic blood pressure, diastolic blood presstire （DBP）. and triglycerides were all significantly different among Groups 1,2, and 3 （ 111.90 ± 12.85 mmHg vs. 114.60 ± 12.88 mmHg vs. 129.43 ±16.21 mmHg, P 〈 0.001 ： 68.77 ± 8.63 mmHg vs. 71.87 ± 9.77 mmHg vs. 82.57 ± 14.89 mmHg, P 〈 0.001 ; and 1.44 [0.91-2.47] mmol/L vs. 0.98 [0.78-1.26] mmol/L vs. 2.20 [0.94-3.66] mmol/L P = 0.030： respectively）, as were creatinine （57.50 [52.00-69.00] mmol/L vs. 55.50 [49.00-64.00] mmol/L vs. 64.00 [56.00-86.00] mmol/L P = 0.045） and blood urea nitrogen （4.27 [3.79-6.22] mmol/L vs. 4.16 [3.47-4.84] mmol/L vs. 5.88 [4.04-8.19] mmol/L, P = 0.011 ）. NLRs were significantly different among Groups 1, 2, and 3 （2.16 [1.56-3.42] vs. 3.12 [1.91-4.19] vs. 5.29 [2.63-7.25], P = 0.001）. N LR, together with DBP and the SLE disease activity index, independently predicts PWV. Conclusions： This study demonstrated that there was a positive correlation between NLR and PWV. Moreover, we found that disease activity and DBP were also positively correlated with PWV.展开更多
文摘BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.
文摘Background： The incidence of atherosclerosis-related myocardial infarction can be as much as 50-fold greater in young patients with systemic lupus e~,thematosus （SLE） than in age-matched controls. There are several explanations for this phenomenon, all of which result in a chronic state of low-grade inflammation. Recently, the neutrophil-to-lynlphocyte ratio （NLR） has been proposed as a useliil biomarker of inflammation. Pulse wave velocity （PWV） is a reliable indicator of vascular damage and atherosclerosis. There is a paucity of data concerning the relationship between NLR and atherosclerosis as measured by PWV in patients with SLE. This study aimed to verify whether there is a positive correlation between NLR and PWV and to explore factors that influence PWV in young SLE patients. Methods： A total of 90 female patients with SLE were enrolled in this cross-sectional investigation. Traditional and nontraditional cardiovascular risk factors were assessed on the same day that brachial-ankle PWV （baPWV） was examined. The patients were divided into three groups according to their mean baPWV values： patients whose mean baPWV value was lower than the first tertile were placed in Group 1 ： patients whose mean baPWV value was between the first tertile and the second tertile were placed in Group 2： and patients whose mean baPWV value was higher than the second tertile were placed in Group 3. SPSS 20.0 was used to perform all statistical analyses in this study. Both univariate linear regression and multivariate regression models were utilized to analyze the association between NLR and arterial stiffness. Results： Systolic blood pressure, diastolic blood presstire （DBP）. and triglycerides were all significantly different among Groups 1,2, and 3 （ 111.90 ± 12.85 mmHg vs. 114.60 ± 12.88 mmHg vs. 129.43 ±16.21 mmHg, P 〈 0.001 ： 68.77 ± 8.63 mmHg vs. 71.87 ± 9.77 mmHg vs. 82.57 ± 14.89 mmHg, P 〈 0.001 ; and 1.44 [0.91-2.47] mmol/L vs. 0.98 [0.78-1.26] mmol/L vs. 2.20 [0.94-3.66] mmol/L P = 0.030： respectively）, as were creatinine （57.50 [52.00-69.00] mmol/L vs. 55.50 [49.00-64.00] mmol/L vs. 64.00 [56.00-86.00] mmol/L P = 0.045） and blood urea nitrogen （4.27 [3.79-6.22] mmol/L vs. 4.16 [3.47-4.84] mmol/L vs. 5.88 [4.04-8.19] mmol/L, P = 0.011 ）. NLRs were significantly different among Groups 1, 2, and 3 （2.16 [1.56-3.42] vs. 3.12 [1.91-4.19] vs. 5.29 [2.63-7.25], P = 0.001）. N LR, together with DBP and the SLE disease activity index, independently predicts PWV. Conclusions： This study demonstrated that there was a positive correlation between NLR and PWV. Moreover, we found that disease activity and DBP were also positively correlated with PWV.
