Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2014; 20(32): 11443-11450
Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11443
Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: A real diagnostic challenge
Carlos Alberto García López, Fernando Laredo-Sánchez, José Malagón-Rangel, Miguel G Flores-Padilla, Haiko Nellen-Hummel
Carlos Alberto García López, Fernando Laredo-Sánchez, José Malagón-Rangel, Miguel G Flores-Padilla, Haiko Nellen-Hummel, Department of Internal Medicine, Specialities Hospital, National Medical Centre “Siglo XXI”, Mexican Social Security Institute, Distrito Federal 06720, México
Author contributions: García López CA, Laredo-Sánchez F, Malagón-Rangel J and Flores-Padilla MG had contact with the patients and collected their information; García López CA and Laredo-Sánchez F designed the idea and prepared the figures for the manuscript; Malagón-Rangel J synthesized the text; Flores-Padilla MG reviewed and revised the manuscript; Nellen-Hummel H reviewed and revised the final manuscript; García López CA was responsible for writing the manuscript.
Correspondence to: Carlos Alberto García López, MD, Department of Internal Medicine, Specialities Hospital, National Medical Centre “Siglo XXI”, Mexican Social Security Institute, Avenida Cuauhtémoc 330, Colonia Doctores, Delegación Cuauhtémoc, Distrito Federal 06720, México. calb.garlo@gmail.com
Telephone: +52-155-56276909 Fax: +52-155-56276909
Received: January 5, 2014
Revised: March 11, 2014
Accepted: April 15, 2014
Published online: August 28, 2014
Processing time: 236 Days and 9.2 Hours
Abstract

Intestinal pseudo-obstruction secondary to systemic lupus erythematosus (SLE) is a rare syndrome described in recent decades. There are slightly over 30 published cases in the English language literature, primarily associated with renal and hematological disease activity. Its presentation and evolution are a diagnostic challenge for the clinician. We present four cases of intestinal pseudo-obstruction due to lupus in young Mexican females. One patient had a previous diagnosis of SLE and all presented with a urinary tract infection of varying degrees of severity during their evolution. We consider that recognition of the disease is of vital importance because it allows for establishing appropriate management, leading to a better prognosis and avoiding unnecessary surgery and complications.

Keywords: Intestinal pseudo-obstruction; Systemic lupus erythematosus; Uretero-hydronephrosis; Urinary tract infection; Diagnostic challenge

Core tip: We present a summary of the most important clinical points in four clinical cases of intestinal pseudo-obstruction secondary to systemic lupus erythematosus using a suggested approach in order to reach a prompt diagnosis due to this pathology presenting a picture of acute abdomen. It is a case series of Mexican patients and, to the best of our knowledge in this particular presentation, is the first report in the international medical literature.