A Rare Initial Manifestation of Systemic Lupus Erythematosus-Acute Pancreatitis with Multiple Complications

以急性的胰臟炎作爲紅斑性狼瘡的最初表現是非常少見的，卻常常會致命。我們報告一位23歲女性病患因腹痛和腹水隨後發生急性肺損傷，同時發現胰臟酵素值上升，在經由電腦斷層確認後，初期診斷爲急性胰臟炎。然而接著同時發生了多種系統性疾病，包括抽搐、全血球缺乏、漿膜炎。經由更進一步的檢查如ANA (1:160)和anti-dsDNA (1:1280)指數上升，才確認是紅斑性狼瘡。於是馬上使用高劑量類固醇治療，接著使用口服類固醇和azathioprine治療2個月之後，病患逐漸恢復正常。當我們遇到不明原因的急性胰臟炎時就必須要把紅斑性狼瘡納入鑑別診斷，因爲積極的以免疫抑制劑治療可以拯救病患的生命。

關鍵字

急性胰臟炎；系統性紅斑性狼瘡；腹痛；併發症

並列摘要

Acute pancreatitis as an initial presentation of systemic lupus erythematosus is rare, but its outcome is often fatal. We report a 23-year-old female patient presenting with abdominal pain and ascites followed by acute lung injury. Increased serum amylase (717 IU/l) and lipase (5579 IU/l) levels suggested acute pancreatitis with complications, which was confirmed by computerized tomography. Multisystemic involvement including seizure, pancytopenia and serositis suggested SLE, which was confirmed later by increased ANA (1:160) and anti-dsDNA (1:1280) levels. Pulse steroids (1 g of Ⅳ methylprednisolone per day for three doses) were administered promptly, followed by a 2-month treatment with oral steroids and azathioprine, and the patient recovered. We should keep a high index of suspicion of the diagnosis, when we meet patient with acute idiopathic pancreatitis. Aggressive treatment with immunosuppressant may save the patient's life.

並列關鍵字

Acute pancreatitis ； Systemic lupus erythematosus ； Abdominal pain ； Complications

國際替代計量

A Rare Initial Manifestation of Systemic Lupus Erythematosus-Acute Pancreatitis with Multiple Complications

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