Lupus Peritonitis

Posted by e-Medical PPT Wednesday, August 1, 2012
SLE-Disorder characterized by presence of autoantibodies and clinical manifestations involving autoimmune inflammation that may affect nearly every organ and tissue.

GI manifestations of SLE
Oral cavity ulcerations and Sjogrens
Esophagitis and esophageal dysmotility
PUD, especially if NSAIDs used
Small vessel vasculitis affecting the large or small intestine
Pancreatitis
IBD: UC, Crohns, collagenous colitis
Celiac disease
Protein-losing enteropathy
Fat malabsorption

Lupus peritonitis
Typically categorized under “serositis” however in some sources included under “GI manifestations of SLE”
True prevalence unknown

Serositis
Inflammation of the serous membranes including the pericardium, pleura and peritoneum which may lead to  pain, fluid accumulation, adhesion and even fibrosis.
Pleuritis is the most commonly reported of the three

Abdominal pain reported in 8-37% of SLE patients
DDx for abdominal pain in lupus is broad and includes both disease-related and non- diseases-related entities.
8-11% of SLE patients develop ascites
Ascites may be due to causes other than lupus peritonitis (hypoalbuminemia, R heart failure, hepatic vein thrombosis, malignancy, infective peritonitis 2/2 bowel infarction, TB)
Ascitic fluid: WBC 10-1630 with lymph/ mono predominance), SAAG< 1.1
In laparotomy patients: peritoneum is hyperemic and thickened, nodular or adhesive, or normal
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