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Background: Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease. Lupus mesenteric vasculitis (LMV) is known as life- threatening presentation of gastrointestinal involvement in lupus. The aim of this retrospective cohort study is to evaluate the etiology of acute abdominal pain in SLE patients who were referred to the emergency room (ER).
Evaluate the prevalence of lupus mesenteric vasculitis (LMV) among systemic lupus erythematosus (SLE) patients presenting with acute abdominal pain in the emergency room.
Assess the demographic characteristics, clinical features, and disease duration of SLE patients with acute abdominal pain admitted to the emergency room.
Compare the diagnostic characteristics, including laboratory findings and imaging results, between SLE patients with LMV and those with other causes of acute abdominal pain.
Determine the association between LMV and specific clinical manifestations, such as generalized abdominal pain, bowel wall thickening, elevated LDH levels, higher ESR, and CT scan abnormalities.
Provide insights into the distinct clinical profile and diagnostic indicators of LMV in SLE patients experiencing acute abdominal pain.
Methods: In this retrospective cohort study we evaluated SLE cases presenting to the ER of one of the referral Hospitals of Tehran University of Medical Sciences (TUMS) with acute abdominal pain, from March 2004 to March 2019. Clinical features, laboratory findings, and imaging results were collected from the hospital records.
Results: Over a 15-year period, 28 SLE patients were admitted to the ER with acute abdominal pain. The study consisted predominantly of females (89.3%, 25/28), with a median age of 34 years (IQR: 29-38) and a median disease duration of 7 years (IQR: 5-9). Lupus mesenteric vasculitis (LMV) was diagnosed in 32% (9/28) of lupus patients with acute abdominal pain. In the LMV subgroup, 88.9% (8/9) were female, with a median age of 35 years (IQR: 32-45) and a median disease duration of 4 years (IQR: 3-14). The other diagnosis of acute abdominal pain including: gastroenteritis (8 patients, 28.6%), serositis (3 patients, 10.7%), pancreatitis (3 patients, 10.7%), gastritis/esophagitis (5 patients, 17.9%) and drug complications (1 patient, 3.6%). LMV was significantly associated with generalized abdominal pain (88.9% vs. 26.3%, p=0.002), bowel wall thickening (55.6% vs 0%, p<0.001), and elevated LDH (88.9% vs 42.1%, p=0.019), compare to non-vasculitis cases. Also, LMV patients showed higher ESR (median: 50 vs. 25, p=0.724) and more frequent CT scan abnormalities (100% vs. 21.1%, p<0.001).
Conclusion: This study showed lupus patients with LMV had more generalized abdominal pain, bowel wall thickening, elevated LDH, higher ESR and more frequent CT scan abnormalities.
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Acknowledgements: Dr. Khashayar Dannandeh, Dr. Saman sarhangzadeh.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (