A Report Of Seven Cases With The Rare Manifestations Of Systemic Lupus Erythematosus And Review Of Literature

【Objective】To analysis the clinical data of the rare manifestations of systemic lupus erythematosus(SLE) so as to improve the recognition, diagnosis SLE earlier and improve the prognosis.【 Methods 】 We recorded and analysed the date of clinical history, auxiliary examinations, treatment and outcome in 7 cases with the rare manifestations of SLE in the Second Affiliated Hospital of Fujian Medical University from September 2013 to January 2016.【Results】The seven cases of SLE with the rare manifestations included a case of splenic infarction, a case of diffuse alveolar hemorrhage(DAH), a case of intestinal obstruction, a case of bowel perforation, a case of cerebral infarction, a case of myocardial infarction and a case of rhodococcus equi infection, respectively. In the case of SLE-splenic infarction, we described a young man with a history of SLE for 3 years, who was admitted to hospital with the complaint of left upper abdominal pain which was demonstrated as splenic infarction by computed tomography(CT). The young man was improved and discharged after conservative treatment like immunosuppression therapy, antithrombotic and antiplatelet agengts. In the case of SLEDAH, a young man was send to hospital with the symptoms of DAH, like cough, hemoptysis, as the first manifestation of SLE. Diffuse ground glass opacity in the both lungs was detected on chest CT, and the diagnosis of SLE was proved by examinations. The patient was improved and discharged after treatment. In the case of SLE-intestinal obstruction, we described a 60-year-old woman with a history of SLE and lupus nephritis(LN) was in hospital due to abdominal pain and distention, thought as intestinal obstruction caused by lupus activity. The patient was improved and discharged after treatment like anti-infective and immunosuppression therapy. In the case of SLE-bowel perforation, a 52-year-old woman was admitted to hospital with the complaint of acute abdominal pain which was due to perforation of descending colon demonstrated by surgery. The patient was diagnosed with SLE overlapping rheumatoid arthritis and gastrointestinal tract involvement, gastrointestinal perforation, she suffered from multiple infections and was discharged finally. In the case of SLE-cerebral infarction, we described a young man with a history of SLE, LN and antiphospholipid syndrome was admitted to hospital with the symptom of right upper limb weakness. MRI proved cerebral infarction, and the symptom was improved after timely treatment, obviously. In the case of SLE- myocardial infarction, a young man was diagnosed with SLE, LN and coronary inflammation, and two coronary artery stents were implanted to him successively. In the case of rhodococcus equi infection in SLE, we described a young man with shortness of breath and chest pain, rhodococcus equi was found in hydrothorax bacteria culture. The patient was improved with effective anti-infective treatment.【Conclusion】SLE can involve multiple systems and organs with complex and varied clinical manifestations, which can manifest as splenic infarction, DAH, intestinal obstruction, bowel perforation, cerebral infarction, myocardial infarction, etc. With the use of immunosuppression therapy for SLE, it is more susceptible to infection, which can cause rhodococcus equi infection. Timely and correct diagnosis of SLE, treatment against etiology can improve the prognosis.