1. Abdominal Pain in SLE

2. Occurs in up to 30% of Systemic Lupus patients
Differential diagnosis is the same as in patients
without SLE, however special consideration
should be given to the following disorders.

3. In Immunosuppressed patients, infection with
CMV may cause abdominal pains and GI
bleeding.

4. Peritonitis
An often overlooked cause of abdominal pain in
SLE patients.
Although clinical peritonitis is rarely suspected,
autopsy suggest that 60 – 70% of patients had
an episode of peritonitis.

5. If CT abdomen showed intraperitoneal
collection, paracentesis is warranted to exclude
infection.

6. Mesenteric vasculitis
A life-threating disorder characterized by Lower
abdominal pain, generally insidious that may be
intermittent for months before development of
acute abdomen.
Associated with nausea, vomiting, diarrhea, GI
bleeding and fever.

7. Risk factors include peripheral vasculitis, CNS
lupus and anti-phospholipid syndrome.
Diagnosed by imaging and endoscopy:

8. Treatment
• Patient kept NPO, blood culture obtained
• Broad spectrum antibiotic
• Three days of IV pulse steroid (1- 1.5 gm) plus
IV cyclophosphamide (1gm)
• After 7 – 10 days another bolus of
cyclophosphamide (750 mg/m2)
• Surgery in case of perforation or failed medical

9. Pancreatitis
• Occur in 2 – 8 % usually in patients with active
SLE
• Presentation does not differ patients without
SLE
• May result from vasculitis or thrombosis
• Treatment include IV fluids, NPO
• Systemic steroids may be given

10. Liver disease
• Hepatomegaly in 50% of patients
• Potential causes: SLE itself (Lupoid –
Autoimmune hepatitis) and NSAIDS

11. Protein-losing enteropathy
Usually occur in young women presenting with
diarrhea, profound edema, hypoalbuminemia in
absence of nephrotic range protienurea.

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