Prevalence, clinical features, and possible associated factors of mesenteric vasculitis occurrence in patients with systemic lupus erythematosus: An age-, year-at SLE diagnosis, and disease duration-controlled study.

Abstract

ObjectivesStudies on associated or risk factors of lupus mesenteric vasculitis (LMV) in patients with systemic lupus erythematosus (SLE) are limited. This study aimed to determine the prevalence, clinical features, treatment, and outcomes of LMV in Thai SLE patients, and to identify potential factors that predispose to its occurrence.MethodsSLE patients with LMV were identified in a lupus cohort. Controls were matched to cases by age-, year-at SLE diagnosis, and disease duration (cases:controls = 1:2).ResultsOf 1538 patients in the cohort, 34 (2.2%) had 42 LMV episodes, but 39 episodes from 31 patients had adequate data for analysis. Nausea, vomiting and diarrhea were noted in 61.5%-69.2%. All of the patients had abdominal pain (diffuse in 64.1%), and 12.8%-15.4% had signs of peritoneal irritation. Small bowel and colon were common sites involved. All episodes responded well to corticosteroids and immunosuppressive drugs. When compared to the controls, at LMV onset, LMV patients had more active disease in renal, mucocutaneous and hematologic systems. They had a higher degree of proteinuria, and SLE disease activity (mSLEDAI-2K score). At 3 months prior to LMV onset, the LMV group was more anemic and had higher proteinuria. The LMV patients received less prednisolone and fewer immunosuppressive drugs at LMV onset, and fewer immunosuppressive drugs at 3 months prior to it. They received a higher daily dose of prednisolone in both periods.ConclusionLMV is a rare manifestation in SLE. Active disease, particularly in the renal and hematologic systems, was common prior to LMV onset.