Journal of Clinical Pediatrics ›› 2026, Vol. 44 ›› Issue (1): 56-63.doi: 10.12372/jcp.2026.24e0351
• Pediatric Grand • Previous Articles Next Articles
LIANG Zhiru1,2, GUO Linmei1, WANG Fei1,2, ZHAO Xiaoyun1(
)
Received:2024-04-16
Accepted:2025-01-10
Published:2026-01-15
Online:2026-01-05
CLC Number:
LIANG Zhiru, GUO Linmei, WANG Fei, ZHAO Xiaoyun. Lupus enteritis or inflammatory bowel disease: a report of the diagnosis and treatment of systemic lupus erythematosus complicated with gastrointestinal symptoms[J].Journal of Clinical Pediatrics, 2026, 44(1): 56-63.
Table 1
The patient's main diagnosis and treatment options and timeline of the patient's course of illness"
| 时 间 | 临床表现、检查及治疗方案 |
|---|---|
| 2018年2月 | 间断腹痛伴双下肢疼痛10天,发热1天。血常规示WBC 2.44×109·L-1、NEU 1.19×109·L-1、RBC 2.19×1012·L-1、 Hb 63g·L-1、PLT 195×109·L-1;粪常规示隐血试验弱阳性;ESR 77 mm·h-1;ANA阳性(1∶320)、抗dsDNA抗体弱阳性、抗Sm抗体阳性、抗rRNP抗体阳性、抗U1-snRNP抗体阳性。诊断为SLE、心包积液、重度缺铁性贫血,给予泼尼松(10 mg,tid)治疗。 |
| 2018年3月 | 发热伴间断腹痛7天,体温39 ℃,入院后诊断为SLE活动期。给予泼尼松(25 mg,bid)联合环磷酰胺冲击治疗。 |
| 2020年2月 | 于第11次环磷酰胺冲击前3天出现频繁呕吐伴剑突下疼痛,头颅核磁及腰椎穿刺未见异常,诊断为活动性SLE、LE。院内甲泼尼龙冲击(600 mg,qd)联合静注免疫球蛋白(10 g,qd)治疗3天。出院后给予泼尼松 (15 mg,qd)联合羟氯喹(0.08 g,bid)治疗。 |
| 2022年8月 | 发热伴腹痛、稀便2天,腹部核磁示腹腔内部分肠管扩张并积液、积气;肝左内叶囊肿;腹膜后、双侧髂血管旁及腹股沟区多发增大淋巴结;盆腔少量积液。胃镜下见贲门炎症。诊断为LE、肝囊肿。给予泼尼松(30 mg,qd)联合羟氯喹(0.075 g,bid)、吗替麦考酚酯(0.75 g,bid)。 |
| 2023年9月 | 腹痛4天,考虑低活动性SLE,给予抗感染、调理肠道菌群、保护胃肠黏膜治疗。继续给予泼尼松联合羟氯喹、吗替麦考酚酯治疗。 |
| 2024年1月 | 右上腹持续钝痛6天,无发热。血常规示WBC 10.51×109·L-1、NEU 9.63×109·L-1、LYM 0.27×109·L-1、PLT 239×109·L-1;CRP 74.8 mg·L-1;ANA(1∶320)、抗rRNP抗体阳性、抗U1-snRNP抗体阳性;ESR 47 mm·h-1。肠镜检查示升结肠肝曲侧-横结肠中段见多发半环周不规则溃疡形成,覆白苔,周围黏膜充血。病理结果示黏膜组织,灶性上皮脱落,肉芽组织增生,间质炎细胞浸润,符合溃疡征象,伴急性活动期炎症改变。诊断为SLE、UC。给予泼尼松(40 mg·d-1)、羟氯喹(0.075 g,bid)、吗替麦考酚酯(0.75 g,bid)联合英夫利昔单抗治疗。 |
| 2024年3月 | 入院复查,给予英夫利西单抗序贯治疗。ANA阳性(1∶100)、抗rRNP抗体阳性、抗U1-snRNP抗体阳性; ESR 8 mm·h-1,肠镜显示横结肠中段见半环周浅溃疡形成。覆薄白苔,周围黏膜充血,呈挛缩、缩窄状。其对侧见白色瘢痕形成。较未治疗前溃疡数量明显减少、面积缩小,呈愈合趋势。 |
| 2025年4月 | 入院复查,ANA阳性(1∶100)、抗rRNP抗体阳性、抗U1-snRNP抗体阳性;便常规示正常。肠镜显示降结肠、直肠黏膜略肿胀,血管网清晰,肠管舒缩好,未见异常病变。 |
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