Title |
Fatal evolution of systemic lupus erythematosus associated with Crohn's disease
|
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Published in |
Arquivos de Gastroenterologia, December 2001
|
DOI | 10.1590/s0004-28032000000400007 |
Pubmed ID | |
Authors |
Júlio M. Fonseca CHEBLI, Pedro Duarte GABURRI, Aécio Flávio Meirelles de SOUZA, Kátia Valéria Bastos DIAS, Karla Oliveira CIMINO, Roberto José de CARVALHO-FILHO, Fernando de Azevedo LUCCA |
Abstract |
The authors describe the case of a young Brazilian woman who was treated of ileocolonic Crohn's disease sparing rectum, as confirmed by colonoscopy and histopathological examination. After a 4-year course of sulfasalazine treatment, she presented with skin facial lesions in vespertilio, fever, arthralgias and high titers of anti-ANA and LE cells. A sulfasalazine-induced lupus syndrome was diagnosed, because after sulfasalazine withdrawal and a short course of prednisone, the clinical symptoms disappeared and the laboratory tests returned to normal. Mesalazine 3 g/day was started and the patient remained well for the next 3 years, when she was again admitted with fever, weakness, arthralgias, diplopy, strabismus and hypoaesthesia in both hands and feet, microhematuria, haematic casts, hypocomplementemia and high titers of autoimmune antibodies. A diagnosis of associated systemic lupus erythematosus was made. Although a pulsotherapy with methylprednisolone was started, no improvement was noticed. A cyclophosphamide trial was tried and again no positive results occurred. The patient evolved to severe clinical manifestations of general vasculitis affecting the central and peripheral nervous system and lungs, having a fatal evolution after 2 weeks. Although uncommon, the association of both disease may occur, and the authors call attention to this possibility, making a brief review of literature. |
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Student > Doctoral Student | 1 | 10% |
Other | 0 | 0% |
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Agricultural and Biological Sciences | 1 | 10% |
Unknown | 3 | 30% |