Lupus Enteritis: An Atypical Initial Presentation of Systemic Lupus Erythematosus

Systemic lupus erythematosus may rarely present initially with gastroenteric features labelled as lupus enteritis, that may lead to serious complications, if it remains undiagnosed for a long period of time. It is difficult to diagnose because the clinical picture of lupus enteritis mimics gastroenteritis. The diagnosis is made on radiological findings, rather than histopathology, and supported by autoimmune profile. Here is a case of a 40-year lady who presented with diarrhea and vomiting that was unresponsive to treatment with intravenous antibiotics. The diagnosis of lupus enteritis was made on the basis of CT scan abdomen, that showed classic target sign due to bowel edema. There was non-specific inflammation found in the biopsy specimen taken on colonoscopy and her autoimmune workup showed ANA and anti-ds-DNA positive. She was treated with high dose of intravenous steroids and recovered.