Lupus with initial mesenteric vasculitis.

Abstract

A 39-year-old woman was admitted because of abdominal pain, nausea, and vomiting after meals for 2 days. She also had fecal incontinence, urination frequency, and urgency for 4 days. She had no specific past medical history. Physical examination revealed diffuse abdominal distension, tender - ness below the sternum, and rebound pain without rigidity. Laboratory tests showed mild anemia, positive homogeneous pattern antinuclear antibody (ANA) with a titer of 1:320, she was also positive for anti-U1-RNP antibodies, anti-double-stranded DNA antibodies, anti-nucleosome antibodies, anti-SSA antibodies, anti-RO-52 antibodies, and anti-histone antibodies, with decreased complements levels. Her D-dimer was 2745 μ g/L. Enhanced computed tomography of the abdomen revealed diffuse circumferential wall thickening with submucosal edema of the entire small bowel, accompanied by ascites. “Fence-like” changes of mesenteric vessels with dilatation of bowel loops, thickened bowel walls, and the “double-halo” sign or “target” sign were observed