Korean J Gastroenterol.  2019 May;73(5):299-302. 10.4166/kjg.2019.73.5.299.

Rectal Ulcer Developed in Systemic Lupus Erythematosus without Ischemic Colitis

• Sohn KC
• Heo WG
• Chu MS
• Kim EJ
• Chung JH
• Choi SC
• Yun KJ
• Seo GS

• KMID: 2447600
• DOI: http://doi.org/10.4166/kjg.2019.73.5.299

Abstract

Rectal involvement by systemic lupus erythematosus (SLE) is quite rare. Approximately 14 cases have been reported worldwide, but only one with ischemic colitis has been reported in Korea. A 17-year-old female patient was hospitalized with abdominal pain and hematochezia. Sigmoidoscopy revealed only a simple rectal ulcer without ischemic colitis. cytomegalovirus and bacterial infections were excluded. A sigmoidoscopic rectal biopsy indicated a rectal invasion by SLE, but the patient showed an acute worsening conditions that did not respond to treatment. This paper reports a case of rectal ulcer that developed in SLE without ischemic colitis with a review of the relevant literature.

Keyword

Lupus erythematosus, systemic; Rectal ulcer; Colitis, ischemic

MeSH Terms

Abdominal Pain
Adolescent
Bacterial Infections
Biopsy
Colitis, Ischemic*
Cytomegalovirus
Female
Gastrointestinal Hemorrhage
Humans
Korea
Lupus Erythematosus, Systemic*
Sigmoidoscopy
Ulcer*

Figure

• 

  Fig. 1 Abdomen and pelvic computed tomography (coronal view) shows diffuse, severe edematous wall thickening of the entire colon (arrows), and a large amount of ascites (arrowhead).

• 

  Fig. 2 Sigmoidoscopic examination showing a fairly well-marginated ulcer lesion (arrow) without an ischemic background.

• 

  Fig. 3 Sigmoidoscopic rectal biopsy shows much nuclear debris (arrows) (H&E, ×200).

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