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Leukoencephalopathy and chronic pancreatitis as concomitant manifestations of systemic lupus erythematosus related to anticardiolipin antibodies

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Symptoms of leukoencephalopathy led to hospital admission of a 59-year-old woman. In addition, a tumor of unknown nature in the pancreas was identified by abdominal ultrasound and CT scan. Following explorative laparotomy and pancreas tail resection, histopathologic analysis revealed a pancreatic pseudotumor with chronic fibrotic pancreatitis. Systemic lupus erythematosus (SLE) was diagnosed due to the presence of antinuclear antibodies (ANA) in serum, antiphospholipid antibodies, and involvement of the central nervous system. Leukoencephalopathy related to anticardiolipin antibodies in serum is a known but rare manifestation of SLE. The concomitant occurrence of chronic pancreatitis can be caused by the development of SLE-induced vasculitis in the pancreas. Subsequent complications of pancreatitis are responsible for the critical, life-threatening state of these patients and may be prevented by early identification of anticardiolipin antibodies and therapy for SLE.

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References

  1. Borum M, Steinberg W, Steer M, Freedman S, White P (1993) Chronic pancreatitis: a complication of systemic lupus erythematosus. Gastroenterology 104:613–615

    CAS  PubMed  Google Scholar 

  2. Bruijn JA, van Alada-Kuipers GA, Smit VT, Eulderink F (1986) Acute pancreatitis in systemic lupus erythematosus. Scand J Rheumatol 15:363–367

    CAS  PubMed  Google Scholar 

  3. Eaker EY, Tokes PP (1989) Case report: systemic lupus erythematosus presenting initially with acute pancreatitis and review of literature. AmJ Med Sci 297:38–41

    CAS  Google Scholar 

  4. Falko JM, Thomas FB (1975) Acute pancreatitis due to procainamide-induced lupus erythematosus. Ann Intern Med 83:823–823

    Google Scholar 

  5. Fields RA, Sibbitt WL, Toubbeh H, Bankhurst AD (1990) Neuropsychiatric lupus erythematosus, cerebral infarctions and anticardiolipin antibodies. Ann Rheum Dis 49:114–117

    CAS  PubMed  Google Scholar 

  6. Harris EN, Gharavi AE, Asherson RA, Boey ML, Hughes GR (1984) Cerebral infarction in systemic lupus: association with anticardiolipin antibodies. Clin Exp Rheumatol 2:47–51

    CAS  PubMed  Google Scholar 

  7. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725 (letter)

    CAS  Google Scholar 

  8. Huang JL, Huang CC, Chen CY, Hung IJ (1994) Acute pancreatitis: a early manifestation of systemic lupus erythematosus. Pediatr Emerg Care 10:291–293

    CAS  PubMed  Google Scholar 

  9. Jaspersen D (1992) Gastrointestinale Manifestationen des systemischen Lupus erythematodes. Symptomatik, Diagnostik und Differentialdiagnostik. Fortschr Med 110:167–169

    CAS  PubMed  Google Scholar 

  10. Kolk A, Horneff G, Wilgenbus KK, Wahn V, Gerharz CD (1995) Acute lethal necrotising pancreatitis in childhood systemic lupus erythematosus—possible toxicity of immunosuppressive therapy. Clin Exp Rheumatol 13:399–403

    CAS  PubMed  Google Scholar 

  11. Leong KP, Boey ML (1996) Systemic lupus erythematosus (SLE) presenting as acute pancreatitis—a case report. Singapore Med J 37:323–324

    CAS  PubMed  Google Scholar 

  12. Mekori YA, Yaretsky A, Schneider M et al (1980) Pancreatitis in systemic lupus erythematosus: a case report and review of literature. Postgrad Med J 56:145–147

    CAS  PubMed  Google Scholar 

  13. Nwaneri UR, Callender CO, Stevens JE (1995) Lupus pancreatitis. J Natl Med Assoc 87:575–576

    CAS  PubMed  Google Scholar 

  14. Petri M (1992) Pancreatitis in systemic lupus erythematosus: still in search of mechanism. J Rheumatol 19:1014–1016

    CAS  PubMed  Google Scholar 

  15. Reifenstein EC, Reifenstein EC Jr, Reifenstein GH (1939) A variable symptom complex of undetermined etiology with fatal determination. Arch Intern Med 63:552–574

    Google Scholar 

  16. Reynolds JC, Inman RD, Kimberly RP et al (1982) Acute pancreatitis in systemic lupus erythematosus. Report of twenty cases and review of literature. Medicine 61:25–32

    CAS  PubMed  Google Scholar 

  17. Seifert VG, Meinz N, Ruffman A (1967) Pankreatitis bei visceralem lupus erythematosus. Gastroenterologia 107:317–327

    CAS  PubMed  Google Scholar 

  18. Takasaki M, Yorimitsu Y, Takahashi I, Miyake S, Horimi T (1995) Systemic lupus erythematosus presenting with drug-unrelated acute pancreatitis as an initial manifestation. Am J Gastroenterol 90:1172–1173

    CAS  PubMed  Google Scholar 

  19. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277

    PubMed  Google Scholar 

  20. Wang CR, Hsieh HC, Lee GL, Chuang CY, Chen CY (1992) Pankreatitis related to antiphospholipid antibody syndrome in a patient with systemic lupus erythematosus. J Rheumatol 19:1123–1125

    CAS  PubMed  Google Scholar 

  21. Watts RA, Isenberg DA (1989) Pancreatic disease in the autoimmune rheumatic disorders. Semin Arthitis Rheum 19:158–165

    CAS  Google Scholar 

  22. Wolman R, de Gara C, Isenberg D (1988) Acute pancreatitis in systemic lupus erythematosus: report of a case unrelated to drug therapy. Ann Rheum Dis 47:77–79

    CAS  PubMed  Google Scholar 

  23. Yeh TS, Wang CR, Lee YT, Chuang CY, Chen CY (1993) Acute pancreatitis related to anticardiolipin antibodies in lupus patients visiting an emergency department. Am J Emerg Med 11:230–232

    CAS  PubMed  Google Scholar 

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Swol-Ben, J., Bruns, C.J., Müller-Ladner, U. et al. Leukoencephalopathy and chronic pancreatitis as concomitant manifestations of systemic lupus erythematosus related to anticardiolipin antibodies. Rheumatol Int 24, 177–181 (2004). https://doi.org/10.1007/s00296-003-0366-4

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  • DOI: https://doi.org/10.1007/s00296-003-0366-4

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