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Acute acalculous cholecystitis in patients with systemic lupus erythematosus: A unique form of disease flare.
Lupus. 2017 Sep; 26(10):1101-1105.L

Abstract

Objective We aimed to investigate the clinical features of acute acalculous cholecystitis (AAC) in patients with systemic lupus erythematosus (SLE). Methods SLE patients with AAC hospitalized in the Peking Union Medical College Hospital (PUMCH) from January 2001 to September 2015 were retrospectively analyzed. Their medical records were systematically reviewed. The diagnosis of AAC was based on clinical manifestations and confirmed by radiologic findings including a distended gallbladder with thickened wall, pericholecystic fluid and absence of gallstones. Results Among the 8411 hospitalized SLE patients in PUMCH, 13 (0.15%) were identified to have SLE-AAC. Eleven (84.6%) of them were female, with a mean age of 30.1 ± 8.6 years. AAC was the initial manifestation of SLE in four (30.8%) cases. Eleven (84.6%) patients complained of fever and abdominal pain, four (30.8%) had positive Murphy's sign and six (46.2%) had elevated liver enzymes. The median SLE Disease Activity Index was 8.0 (range 0-20.0) at the time of AAC. Other affected organs in SLE-AAC included kidney (11, 84.6%) and hematologic system (11, 84.6%), followed by mucocutaneous (seven, 53.8%), musculoskeletal (seven, 53.8%) and neuropsychiatric (two, 15.4%) systems. All patients received treatment of glucocorticoids and immunosuppressants but none underwent surgical intervention. During a median follow-up of 28 months (range, 2-320 months), 12 cases (92.4%) responded to treatment with no relapse and one patient (7.6%) died of septic shock. Conclusion Our study suggests that AAC is a relatively uncommon and underestimated gastrointestinal involvement of SLE that is often associated with active disease. For patients with AAC in SLE, treatment with aggressive glucocorticoids could result in a good prognosis.

Authors+Show Affiliations

Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, The Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, The Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, The Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, The Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Department of Rheumatology and Clinical Immunology, Clinical Immunology Center, The Ministry of Education Key Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28355987

Citation

Yang, H, et al. "Acute Acalculous Cholecystitis in Patients With Systemic Lupus Erythematosus: a Unique Form of Disease Flare." Lupus, vol. 26, no. 10, 2017, pp. 1101-1105.
Yang H, Bian S, Xu D, et al. Acute acalculous cholecystitis in patients with systemic lupus erythematosus: A unique form of disease flare. Lupus. 2017;26(10):1101-1105.
Yang, H., Bian, S., Xu, D., Zhang, F., & Zhang, X. (2017). Acute acalculous cholecystitis in patients with systemic lupus erythematosus: A unique form of disease flare. Lupus, 26(10), 1101-1105. https://doi.org/10.1177/0961203317699288
Yang H, et al. Acute Acalculous Cholecystitis in Patients With Systemic Lupus Erythematosus: a Unique Form of Disease Flare. Lupus. 2017;26(10):1101-1105. PubMed PMID: 28355987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute acalculous cholecystitis in patients with systemic lupus erythematosus: A unique form of disease flare. AU - Yang,H, AU - Bian,S, AU - Xu,D, AU - Zhang,F, AU - Zhang,X, Y1 - 2017/03/29/ PY - 2017/3/31/pubmed PY - 2018/5/8/medline PY - 2017/3/31/entrez KW - Acute acalculous cholecystitis (AAC) KW - disease activity KW - systemic lupus erythematosus (SLE) SP - 1101 EP - 1105 JF - Lupus JO - Lupus VL - 26 IS - 10 N2 - Objective We aimed to investigate the clinical features of acute acalculous cholecystitis (AAC) in patients with systemic lupus erythematosus (SLE). Methods SLE patients with AAC hospitalized in the Peking Union Medical College Hospital (PUMCH) from January 2001 to September 2015 were retrospectively analyzed. Their medical records were systematically reviewed. The diagnosis of AAC was based on clinical manifestations and confirmed by radiologic findings including a distended gallbladder with thickened wall, pericholecystic fluid and absence of gallstones. Results Among the 8411 hospitalized SLE patients in PUMCH, 13 (0.15%) were identified to have SLE-AAC. Eleven (84.6%) of them were female, with a mean age of 30.1 ± 8.6 years. AAC was the initial manifestation of SLE in four (30.8%) cases. Eleven (84.6%) patients complained of fever and abdominal pain, four (30.8%) had positive Murphy's sign and six (46.2%) had elevated liver enzymes. The median SLE Disease Activity Index was 8.0 (range 0-20.0) at the time of AAC. Other affected organs in SLE-AAC included kidney (11, 84.6%) and hematologic system (11, 84.6%), followed by mucocutaneous (seven, 53.8%), musculoskeletal (seven, 53.8%) and neuropsychiatric (two, 15.4%) systems. All patients received treatment of glucocorticoids and immunosuppressants but none underwent surgical intervention. During a median follow-up of 28 months (range, 2-320 months), 12 cases (92.4%) responded to treatment with no relapse and one patient (7.6%) died of septic shock. Conclusion Our study suggests that AAC is a relatively uncommon and underestimated gastrointestinal involvement of SLE that is often associated with active disease. For patients with AAC in SLE, treatment with aggressive glucocorticoids could result in a good prognosis. SN - 1477-0962 UR - https://www.unboundmedicine.com/medline/citation/28355987/Acute_acalculous_cholecystitis_in_patients_with_systemic_lupus_erythematosus:_A_unique_form_of_disease_flare_ L2 - https://journals.sagepub.com/doi/10.1177/0961203317699288?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -