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BMJ Case Reports 2017; doi:10.1136/bcr-2017-220185
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Systemic lupus erythematosus (SLE): an unusual cause of ileocolic intussusception

  1. Wai-Kwan Lam-Tse3
  1. 1Internal Medicine, Admiraal de Ruyter ziekenhuis, Goes, The Netherlands
  2. 2Department of Rheumatology, Sint Franciscus Vlietland Groep, Rotterdam, The Netherlands
  3. 3Department of Rheumatology, Sint Franciscus Vlietland Groep, Rotterdam, The Netherlands
  1. Correspondence to Drs. Naomi Glijn, nhpglijn{at}gmail.com
  • Accepted 30 October 2017
  • Published 2 December 2017

Summary

Intussusception is a rare diagnosis in adults. Gastrointestinal involvement is not unusual in systemic lupus erythematosus (SLE).1 A case of intussusception as first presenting symptom of SLE is described. A 50-year-old woman of Chinese origin came to the emergency room with symptoms of high fever, nausea, vomiting and weight loss of 10 kg. Three months before, an episode with abdominal pain due to ileal invagination in the colon occurred. Laboratory analysis showed: thrombocytopaenia, lymphopaenia, positive antinuclear antibody, antidouble-stranded DNA, Coombs tests and low C3 in combination with an active urine sediment and proteinuria. CT and positron emission tomography scan showed lymphadenopathy, but no other abnormalities. Axillar lymph node biopsy showed no abnormalities. The diagnosis new-onset SLE was made. Prednisone treatment was started and soon thereafter tapered, azathioprine and hydroxychloroquine were added. During follow-up, the SLE remained in remission. SLE is a rare cause of ileocolic intussusception and ileocolic intussusception may be the first presenting symptom.

Footnotes

  • Contributors NG participated in collecting the patient information and writing of the case report. L-AK participated in collecting the patient information and writing of the case report. W-KL-T initiated the case report and participated in writing of the case report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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