Systemic Lupus Erythematosus in Disguise: Acute Pancreatitis as Initial Presentation

Autor: Saeed Abughazaleh MD, Saqr Alsakarneh MD, Mariana Hattar MD, Fouad Jaber MD, Quinton Palmer MD, Hassan Ghoz MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Investigative Medicine High Impact Case Reports, Vol 11 (2023)
Druh dokumentu: article
ISSN: 2324-7096
23247096
DOI: 10.1177/23247096231185480
Popis: Macrophage activation syndrome (MAS) can rarely coexist with lupus pancreatitis. We report on a 20-year-old woman with abdominal pain, nausea, and vomiting. Laboratories were notable for pancytopenia, elevated liver enzymes, elevated ferritin, lipase, and triglycerides. Chest and abdominal computerized tomography (CT) scans revealed bilateral axillary lymphadenopathy, patchy lower lobe consolidations, small pleural effusions, ascites, and splenomegaly. Peritoneal fluid cytology showed lymphocytes and histiocytes with hemophagocytic changes. Immunological workup met the criteria for systemic lupus erythematosus (SLE). Pulse-dosed steroids relieved her condition. Given the high mortality rate associated with MAS, early detection of concomitant pancreatitis and MAS in the context of underlying SLE is critical.
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