Rectal Ulcer Developed in Systemic Lupus Erythematosus without Ischemic Colitis

Ki Chang Sohn; Won Gak Heo; Min Su Chu; Eui Joong Kim; Jong Hyeok Chung; Suck Chei Choi; Ki Jung Yun; Geom Seog Seo

doi:10.4166/kjg.2019.73.5.299

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Sohn, Heo, Chu, Kim, Chung, Choi, Yun, and Seo: Rectal Ulcer Developed in Systemic Lupus Erythematosus without Ischemic Colitis

Case Report

The Korean Journal of Gastroenterology 2019; 73(5): 299-302.

Published online: 27 May 2019

DOI: https://doi.org/10.4166/kjg.2019.73.5.299

Rectal Ulcer Developed in Systemic Lupus Erythematosus without Ischemic Colitis

Ki Chang Sohn, Won Gak Heo, Min Su Chu, Eui Joong Kim, Jong Hyeok Chung, Suck Chei Choi, Ki Jung Yun¹, Geom Seog Seo

Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.

¹Department of Pathology, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to: Geom Seog Seo, Department of Internal Medicine, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. Tel: +82-63-859-2565, Fax: +82-63-855-2025, medsgs@wonkwang.ac.kr

Received 27 November 2018 Revised 9 January 2019 Accepted 27 January 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rectal involvement by systemic lupus erythematosus (SLE) is quite rare. Approximately 14 cases have been reported worldwide, but only one with ischemic colitis has been reported in Korea. A 17-year-old female patient was hospitalized with abdominal pain and hematochezia. Sigmoidoscopy revealed only a simple rectal ulcer without ischemic colitis. cytomegalovirus and bacterial infections were excluded. A sigmoidoscopic rectal biopsy indicated a rectal invasion by SLE, but the patient showed an acute worsening conditions that did not respond to treatment. This paper reports a case of rectal ulcer that developed in SLE without ischemic colitis with a review of the relevant literature.

Keywords: Lupus erythematosus, systemic, Rectal ulcer, Colitis, ischemic

Figures and Tables

Fig. 1

Abdomen and pelvic computed tomography (coronal view) shows diffuse, severe edematous wall thickening of the entire colon (arrows), and a large amount of ascites (arrowhead).

Fig. 2

Sigmoidoscopic examination showing a fairly well-marginated ulcer lesion (arrow) without an ischemic background.

Fig. 3

Sigmoidoscopic rectal biopsy shows much nuclear debris (arrows) (H&E, ×200).

Table 1

Reported Cases of SLE Complicated with Rectal Involvementa

SLE, systemic lupus erythematosus; F, female; R, rectum; S, sigmoid colon; OP, operation; M, male; CP, cyclophosphamide; TL, tacrolimus.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Geom Seog Seo
https://orcid.org/0000-0001-8789-7989
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