A practical perspective on gastrointestinal manifestations of systemic lupus erythematosus

Abstract

Systemic lupus erythematosus is an autoimmune disease with a tendency to wax and wane. Unlike other autoimmune conditions, disease activity in the gastrointestinal system is relatively rare, and its approach can vary, according to different points of view. Despite its low prevalence, gastrointestinal manifestations can be potentially fatal, as occurs in cases of intestinal vasculitis and the consequent mesenteric ischaemia. The spectrum of gastrointestinal involvement in this disease is broad, and includes disease activity, infection associated with immunosuppression, adverse effects of some medications, or other intercurrent processes such as lupus cystitis. The clinical symptoms and laboratory findings are highly diverse, which leads to a delay in diagnosis with consequent organ dysfunction. Early diagnosis can be a challenge because a large proportion of patients present with nonspecific constitutional symptoms associated with nausea, emesis, and abdominal pain. These numerous factors have been an obstacle to further research in this field, making a unified diagnostic and therapeutic approach difficult. Therefore, an advanced search of the literature will be undertaken to obtain the most evidence available on the diagnostic methods and treatments currently available, providing the clinician with more tools to achieve a comprehensive approach.