A Case of Systemic Lupus Erythematosus Accompanying Huge Colonic Ulcer

• Published in: Progress of Digestive Endoscopy(1972) Vol. 43; pp. 227 - 230
• Main Authors: Taguchi, Tadao, Miyamoto, Toshiaki, Ishihara, Takeshi, Ehata, Toshiki, Iwama, Shosuke, Ishihara, Kazuo, Konno, Akio
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Gastroenterological Endoscopy Society Kanto Chapter 01.12.1993
• ISSN: 0389-9403; 2189-0021; 0389-9403
• DOI: 10.11641/pdensks.43.0_227

Colonic ulcer that is complicated by systemic lupus erythematosus (SLE) is known to be liable to penetrate the intestinal wall, thus leading to a fatal outcome. This paper describes an ulcer that was found penetrating the sigmoid colon in an SLE patient, but with increased dosage of steroid, was cicatrized. The patient was 41-year-old woman. She had been diagnosed as having SLE 19 years before. During prolonged maintenance steroid therapy diarrhea and melena appeared. Colonoscopic studies revealed a longitudinally giant ulcer which was localized in the sigmoid colon and was circumferential at the center and beltlike at the periphery. After one month of hospitalization and steroid therapy with increased dosage the giant ulcer further exacerbated, following out at its center. After five months of steroid therapy, however, the ulcer was cicatrized, though left with slightly converging folds. The ulcer has not recurred to date. No definitive histopathological diagnosis of the ulcer lesion was made in this case, but from an immunological viewpoint it appears that vasculitis was concerned with the development of this ulcer, considering it developed during the aggravation of SLE and that increased dosage of steroid elicited a favorable response.