Colitis and Pancreatitis in a Patient with Systemic Lupus Erythematosus: Due to Disease or to Drug?

• Published in: Digestive diseases and sciences 2018-09, Vol.63 (9), p.2206-2209
• Main Authors: Paleti, Swathi, Yarlagadda, Bharath, Gremida, Anas, Aziz, Muhammad, Hanson, Joshua, McCarthy, Denis
• Format: Article
• Language: English
• Subjects: Apoptosis; Biochemistry; Colitis; Gastroenterology; Hepatology; Inflammatory bowel disease; Kidney diseases; Lupus; Medical colleges; Medicine; Medicine & Public Health; Mycophenolate sodium; Oncology; Pancreatitis; Systemic lupus erythematosus; Transplant Surgery; Unm Clinical Case Conferences
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-018-5225-y

A 37-year-old female with a history of developmental delay, left-sided focal epilepsy due to polymicrogyria, systemic lupus erythematosus (SLE), and stage 3 chronic kidney disease due to lupus nephritis was initially evaluated for diarrhea of 4 months duration. Due to the presence of cognitive issues, her history was obtained from her mother, her primary caregiver. She reported that her daughter had been having 5–6 loose bowel movements per day for 4 months, associated with a weight loss of 15 lbs over this time period, contrasting with the one formed bowel movement per day she had experienced prior to the onset of diarrhea. Moreover, she was stated to have had sharp epigastric pain and intermittent nausea and vomiting for 3 days prior to evaluation and was currently not able to tolerate any oral intake. The patient was hospitalized 1 month prior to the current admission and diagnosed with influenza B. At that time, she was neutropenic with a white blood cell count of 0.7 × 109/dl (4.5–11.0 × 109/dl) which on consultation with the hematology service was attributed to her acute viral infection.