Interestingly, the patient also presented with clinically mild ascites, small pleural effusions and hypoalbuminemia. Although she did have a suggestion of proteinuria on an initial urinalysis, subsequent urinalysis failed to demonstrate an ongoing renal protein loss. Therefore, we feel that in light of the bowel wall thickening and the hypoalbuminemia that there was also an SLE-associated protein-losing enteropathy (PLE).
Unfortunately, a Tc-99 labelled albumin to demonstrate protein loss from the gastrointestinal tract was unavailable, due to a lack of reagent, at the time of initial hospitalization. Of some interest, at our institution, a previous case involving a young Asian woman who was found to have a painless lupus-associated PLE as the first manifestation of otherwise occult SLE was recently reported. Another study reported that nine of 22 cases in the literature of autoimmune associated PLE were from Japan. Thus, we speculate that gastrointestinal lupus may be more common in women of Asian-Pacific descent. Find best deals an online pharmacy can offer and get a chance to start your treatment soon. You can now purchase cheap asthma medications at the best pharmacy that will be sure to live up to your expectations every single time.
Although abdominal pain is a very common complaint in patients with either an established diagnosis of SLE or classic ARA target organ damage, our experience suggests that it may be the initial clinical manifestation of otherwise occult lupus. Furthermore, we suggest that the diagnosis of lupus should be considered when a young Asian woman presents with abdominal pain and unexplained enteropathy because rapid symptomatic improvement may occur with the administration of immunosuppresant therapy.