The clinical characteristics of lupus related protein-losing enteropathy in Hong Kong Chinese population: 10 years of experience from a regional hospital
Lupus,  Clinical Article

Law ST et al. – There appears to be increasing prevalence of systemic lupus erythematosus (SLE) related protein–losing enteropathy (PLE). A diagnosis can be made using 99m Tc–labeled HSA scintigraphy. PLE generally responds well to immunosuppressive therapy.

Methods
  • A retrospective analysis was performed.

Results
  • From 2001 to 2010, 48 patients had SLE related PLE and their clinical characteristics were: age 40.8 ± 14.3 years, male–to–female ratio 1:8.6, mean symptom duration 4.3 ± 3.4 weeks, initial presentation and concomitant activity of SLE in 21(43.8%) and 37 (77.1%) patients, <20% patients developed gastrointestinal (GI) symptoms, mean serum albumin level 24.4 ± 5 g/L.
  • Thirty (62.5%) patients had diffuse non–erosive erythematous GI mucosa with chronic inflammatory cells in lamina propria.
  • Protein leakage was at the small bowel in 15 (31.3%) patients, terminal ileum/caecum in 16 (33.3%) patients and ascending colon in 11 (22.9%) patients.
  • Thirty (62.5%) patients responded initially well to a combination of prednisolone and azathioprine (AZA) and 33 (68.8%) patients were maintained well by the above therapy.
  • Higher potent induction and maintenance therapy were required in patients with: proteinuria (p < 0.01), history of previous immunosuppressive therapy (p < 0.02) and requirement of higher potent induction therapy (p < 0.01).
  • PLE as initial SLE presentation was associated with better prognosis.
  • Four reversible adverse events were reported: one had AZA–induced pancreatitis, two developed AZA–induced hypoplastic anemia and one developed steroid psychosis.
  • One patient developed shingles in the fourth month and responded to oral acyclovir.
  • No thromboembolic events were reported and one patient died of SLE nephropathy.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

2 Sweetened carbonated beverage consumption and cancer risk: Meta-analysis and review European Journal of Cancer Prevention, August 1, 2014    Evidence Based Medicine    Review Article

3 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 1, 2014    Evidence Based Medicine    Clinical Article

4 Evaluation and treatment of older patients with hypercholesterolemia: A clinical review JAMA, October 20, 2014    Clinical Article

5 Lower versus higher hemoglobin threshold for transfusion in septic shock New England Journal of Medicine, October 7, 2014    Evidence Based Medicine    Clinical Article

6 Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: A mendelian randomisation study The Lancet Diabetes & Endocrinology, October 21, 2014    Clinical Article

7 Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review Annals of Internal Medicine, September 29, 2014    Evidence Based Medicine    Review Article    Clinical Article

8 Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial The Lancet, October 16, 2014    Evidence Based Medicine    Clinical Article
Exclusive Author Commentary

9 Total expenditures per patient in hospital-owned and physician-owned physician organizations in California JAMA, October 24, 2014    Evidence Based Medicine    Clinical Article

10 Triglycerides and cardiovascular disease The Lancet, August 19, 2014    Evidence Based Medicine    Clinical Article

11 Nut consumption and the risk of coronary artery disease: A dose–response meta-analysis of 13 prospective studies Thrombosis Research, October 22, 2014    Clinical Article

12 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

13 Association of fat density with subclinical atherosclerosis Full Text Journal of the American Heart Association, September 19, 2014    Free full text

14 A randomized trial of epidural glucocorticoid injections for spinal stenosis New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

15 Ivabradine in stable coronary artery disease without clinical heart failure New England Journal of Medicine, September 2, 2014    Evidence Based Medicine    Clinical Article

16 Livebirth after uterus transplantation The Lancet, October 9, 2014    Evidence Based Medicine    Clinical Article

17 Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial The Lancet, October 14, 2014    Evidence Based Medicine    Clinical Article

18 Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study Full Text Cardiovascular Diabetology, October 17, 2014    Free full text    Clinical Article

19 Readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia among young and middle-aged adults: a retrospective observational cohort study Full Text PLoS Medicine, October 3, 2014    Free full text    Evidence Based Medicine    Clinical Article

20 The influence of whole grain products and red meat on intestinal microbiota composition in normal weight adults: A randomized crossover intervention trial PLOS ONE, October 22, 2014    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore