Massive Ascites as the Initial Manifestation of Systemic Lupus Erythematosus: A Case Report
Z.Boukhal
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
C.Boukhars *
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
T. Simon
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
FZ.El Rhaoussi
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Tahiri
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
F. Haddad
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
W. Hliwa
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
A. Bellabah
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
A. Aallam
Internal Medicine Department, Ibn Rochd University Hospital, Casablanca, Morocco.
L.Barakat
Internal Medicine Department, Ibn Rochd University Hospital, Casablanca, Morocco.
W. Badre
Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Although systemic lupus erythematosus (SLE) can manifest differently in each patient, ascites is a rare first sign. The diagnosis of SLE can be easily missed when the initial presentation is uncommon. This is the case report of a 20 year old woman with no medical history, who experienced 8 months of abdominal distension and weakness, with concurrent 10 kg weight loss. She presented skin lesions of the erythematous type on the dorsal surface of her hands, non-scarring alopecia, Raynaud's syndrome, and joint involvement consisting of symmetrical distal polyarthralgia of the small joints. There were no signs of thyroid dysfunction, cardiac dysfunction, cancers, infectious diseases, hepatitis, kidney diseases, or other diseases.The investigation also allowed the confirmation of SLE. Thus, the hypothesis of lupus peritonitis with ascites became viable. The patient was treated with prednisone and MMF, with substantial improvement of her condition.
Keywords: Ascites, lupus peritonitis, peritoneal serositis, systemic lupus erythematosus