Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: A real diagnostic challenge

Table 1 Characteristics of patients with intestinal pseudo-obstruction due to systemic lupus erythematosus at the time of diagnosis

	Case 1	Case 2	Case 3	Case 4
General information
Age (yr)	27	23	25	37
Time of diagnosis of SLE	0 mo/yr	0 mo/yr	0 mo/yr	12 yr
SLEDAI	27	11	15	10
Clinical signs and symptoms
Weight loss (kg)	10	15	8	NR
Seizures/amaurosis	+	-	-	-
Fever	+	+	+	+
Serositis (pleural effusion)	+	+	+	+
Ascites	+	-	-	-
Dysuria	+	+	+	-
Sepsis	+	+	-	-
Paraclinical tests
Uretero-hydronephrosis (CT)	+	+	+	+
Esophagitis (endoscopy)	+	+	NR	NR
Hypomotility (manometry)	+	+	NR	NR
Laboratory tests
ANA (IU/mL)	2	1.1	3.4	NR
Anti-ds-DNA (IU/mL)	29	34	40	NR
C3 (mg/dL)	36	40	44	36
C4 (mg/dL)	6	3	7	8
Anti-SM (IU/mL)	> 100	NR	NR	NR
Anti-Ro	+	+	-	-
Hemolytic anemia	+	+	+	+
Leucopenia/lymphopenia	+	+	+	+
High CRP	+	+	+	+
Proteinuria (g/24 h)	1.8 to 21	3 to 10.76	10	ESCKD
Blood culture	E. coli	E. coli	-	-
Urine culture	E. coli/PA	E. coli	E. coli	E. coli
Treatment
Methylprednisolone pulse	+	+	+	NU
IV IgG	+	+	NU	NU
Cyclophosphamide	NU	NU	+	NU
Oral prednisolone	+	+	+	+
Prokinetics	+	+	+	+
Antibiotics	+	+	+	+
Others
Total parenteral nutrition	+	+	+	-
Surgery prior to diagnosis	+	+	+	+

+: Positive; -: Negative; SLE: Systemic lupus erythematosus; NU: Not used; NR: Not reported/not realized; ESCKD: End-stage chronic kidney disease; CRP: C-reactive protein; ACR: American College of Rheumatology; CT: Computed tomography; ANA: Antinuclear antibodies (normal, nondetectable); anti-dsSNA: Double-stranded DNA (positives: > 25 IU/mL); C3: C3 Complement (90-189 mg/dL); C4: C4 Complement (10-40 mg/dL); LDH: Lactate dehydrogenase; E. coli: Escherichia coli; PA: Pseudomonas aeruginosa; anti-SM: Anti-smith antibodies; Ro: Anti-Ro antibodies; SLEDAI: Systemic lupus erythematosus disease activity index; IV IgG: Intravenous human immunoglobulin; IU: International units.