Systemic Lupus Erythematosus Associated with Massive Ascites and Pleural Effusion in a Patient Who Presented with Disseminated Intravascular Coagulation

• Published in: Internal Medicine Vol. 41; no. 2; pp. 161 - 166
• Main Authors: KAGEYAMA, Yo, YAGI, Takashi, MIYAIRI, Mamoru
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01.02.2002; Japanese Society of Internal Medicine
• Subjects: Anorexia - etiology; anti-nuclear antibody; Antibodies, Antinuclear - blood; Ascites - etiology; Ascites - immunology; Autoimmune Diseases - blood; Autoimmune Diseases - complications; Autoimmune Diseases - diagnosis; Autoimmune Diseases - drug therapy; Biological and medical sciences; complement; Disseminated Intravascular Coagulation - etiology; Edema - etiology; Female; Fever - etiology; Fibrin Fibrinogen Degradation Products - analysis; Humans; immune complex; Immunosuppressive Agents - therapeutic use; Lupus Erythematosus, Systemic - blood; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - diagnosis; Lupus Erythematosus, Systemic - drug therapy; Medical sciences; Middle Aged; Pleural Effusion - etiology; Prednisolone - therapeutic use; Purpura, Thrombocytopenic, Idiopathic - etiology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; vasculitis; Vasculitis - etiology; Human; Immunopathology; Connective tissue disease; Skin disease; Disseminated intravascular coagulopathy; Effusion; Respiratory disease; Pathogenesis; Cardiovascular disease; Autoimmune disease; Hemopathy; Vascular disease; Case study; Vasculitis; Abdominal disease; Systemic disease; Pleurisy; Pleural disease; Lupus erythematosus; Disseminated; Ascites; Coagulopathy
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.41.161

A case of systemic lupus erythematosus (SLE) associated with serositis presenting with disseminated intravascular coagulation (DIC) is reported. A 53-year-old woman was admitted because of a fever. Laboratory tests revealed increased plasma levels of fibrinogen degradation products (FDP) and FDP-D-dimer, high titers of anti-nuclear antibody, high serum levels of anti-DNA antibody, immune complexes, decreased serum complements, and persistent proteinuria. A CT scan showed massive ascites and pleural effusion, marked edema and swelling of the mesenterium. The patient's condition and immunological abnormalities improved after steroid therapy. The association of DIC and lupus serositis has never been described in the literature. (Internal Medicine 41: 161-166, 2002)