Rheumatology International

, Volume 36, Issue 10, pp 1413–1419 | Cite as

Prevalence, severity, and clinical features of acute and chronic pancreatitis in patients with systemic lupus erythematosus

  • Qiang Wang
  • Min ShenEmail author
  • Xiaomei Leng
  • Xiaofeng Zeng
  • Fengchun Zhang
  • Jiaming Qian
Observational Research


Pancreatitis is a rare, life-threatening complication of systemic lupus erythematosus (SLE). This study aimed to describe the clinical features of acute pancreatitis (AP) and chronic pancreatitis (CP) in patients with SLE. Data of patients who fulfilled the revised criteria of the American Rheumatism Association for diagnosis of SLE were retrospectively analyzed. SLE activity was graded according to the SLE Disease Activity Index. Logistic regression analysis was conducted to find out independent associations. Survival rates were estimated by using Kaplan–Meier plots. This study included 5665 SLE patients admitted between January 1983 and January 2014, of whom 52 patients were diagnosed with pancreatitis. Pancreatitis prevalence in SLE patients was 0.92 % (52/5665). AP (0.8 %, 46/5665) was more prevalent than CP (0.1 %, 6/5665), presented mostly during active SLE, and affected more organs. Hypertriglyceridemia occurred in 76.9 % of AP patients and in none of the CP patients. AP patients were divided into severe (n = 10) or mild (n = 20) cases. The average triglyceride level in severe AP cases was higher than that in mild AP cases (P = 0.006), and the mortality rate of lupus-associated AP was 32.6 % (15/46). Concomitant infections and thrombocytopenia were independently associated with poor prognosis (P < 0.001, P = 0.028, respectively). There were significant differences in the clinical manifestations of AP and CP. Patients with severe AP were found to have a higher incidence of concomitant infection and serum triglyceride levels. Concomitant infections and thrombocytopenia were independent risk factors for poor prognosis.


Systemic lupus erythematosus Acute pancreatitis Chronic pancreatitis 



This work was supported by the National High Technology Research and Development Program of China (2012AA02A513), the National Nature Science Foundation (81501405) and the Peking Union Medical College Youth Fund 2015 (3332015092).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the present study were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Forabosco P, Gorman JD, Cleveland C et al (2006) Metaanalysis of genome-wide linkage studies of systemic lupus erythematosus. Genes Immun 7:609–614CrossRefPubMedGoogle Scholar
  2. 2.
    Firestein GS, Budd RC, Harris ED Jr et al (2008) Kelley’s textbook of rheumatology, 8th edn. W. B. Saunders Company, PhiladelphiaGoogle Scholar
  3. 3.
    Noia JL, Garcia FM, Rios SS et al (2009) Pancreatitis and systemic lupus erythematosus. Rev Esp Enferm Dig 101:571–579Google Scholar
  4. 4.
    Huang JL, Huang CC, Chen CY, Hung IJ (1994) Acute pancreatitis: an early manifestation of systemic lupus erythematosus. Pediatr Emerg Care 10:291–293CrossRefPubMedGoogle Scholar
  5. 5.
    Breuer GS, Baer A, Dahan D, Nesher G (2006) Lupus-associated pancreatitis. Autoimmun Rev 5:314–318CrossRefPubMedGoogle Scholar
  6. 6.
    Makol A, Petri M (2010) Pancreatitis in systemic lupus erythematosus: frequency and associated factors—a review of the Hopkins Lupus Cohort. J Rheumatol 37:341–345CrossRefPubMedGoogle Scholar
  7. 7.
    Yang Y, Ye Y, Liang L et al (2012) Systemic lupus erythematosus–related acute pancreatitis: a cohort from South China. Clin Dev Immunol 2012:564–568Google Scholar
  8. 8.
    Derk CT, Dehoratius RJ (2004) Systemic lupus erythematosus and acute pancreatitis: a case series. Clin Rheumatol 23:147–151CrossRefPubMedGoogle Scholar
  9. 9.
    Nesher G, Breuer GS, Temprano K et al (2006) Lupus-associated pancreatitis. Semin Arthritis Rheum 35:260–267CrossRefPubMedGoogle Scholar
  10. 10.
    Marques VL, Gormezano NW, Bonfa E et al (2016) Pancreatitis subtypes survey in 852 childhood-onset systemic lupus erythematosus patients. J Pediatr Gastroenterol Nutr 62(2):328–334CrossRefPubMedGoogle Scholar
  11. 11.
    Tan EM, Cohen AA, Fries JF et al (1992) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277CrossRefGoogle Scholar
  12. 12.
    Pancreatic Disease Group CSOG, Chinese Medical Association (2005) Consensus on the diagnosis and treatment of acute pancreatitis. Chin J Dig Dis 6:47–51CrossRefGoogle Scholar
  13. 13.
    Pancreas Study Group CSOG (2005) Guidelines for the diagnosis and treatment of chronic pancreatitis (Nanjing, 2005). Chin J Dig Dis 6:198–201CrossRefGoogle Scholar
  14. 14.
    Bombardier C, Gladman DD, Urowitz MB et al (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 35:630–640CrossRefPubMedGoogle Scholar
  15. 15.
    Toskes PP (1990) Hyperlipidemic pancreatitis. Gastroenterol Clin North Am 19:783–791PubMedGoogle Scholar
  16. 16.
    Oh RC, Lanier JB (2007) Management of hypertriglyceridemia. Am Fam Physician 75:1365–1371PubMedGoogle Scholar
  17. 17.
    Deng LH, Xue P, Xia Q et al (2008) Effect of admission hypertriglyceridemia on the episodes of severe acute pancreatitis. World J Gastroenterol 14:4558–4561CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Takaoka K, Kataoka K, Sakagami J (2002) The effect of steroid pulse therapy on the development of acute pancreatitis induced by closed duodenal loop in rats. J Gastroenterol 37:537–542CrossRefPubMedGoogle Scholar
  19. 19.
    Sadr-Azodi O, Mattsson F, Bexlius TS et al (2013) Association of oral glucocorticoid use with an increased risk of acute pancreatitis: a population-based nested case-control study. JAMA Intern Med 173:444–449CrossRefPubMedGoogle Scholar
  20. 20.
    Chiche L, Jourde-Chiche N, Bader-Meunier B et al (2016) Acute pancreatitis as a cause of mortality in pediatric systemic lupus erythematosus: results of a multiple cause-of-death analysis in France. Semin Arthritis Rheum. doi: 10.1016/j.semarthrit.2016.03.009 PubMedGoogle Scholar
  21. 21.
    Gormezano NW, Otsuzi CI, Barros DL et al (2016) Macrophage activation syndrome: a severe and frequent manifestation of acute pancreatitis in 362 childhood-onset compared to 1830 adult-onset systemic lupus erythematosus patients. Semin Arthritis Rheum 45(6):706–710CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Qiang Wang
    • 1
  • Min Shen
    • 2
    Email author
  • Xiaomei Leng
    • 2
  • Xiaofeng Zeng
    • 2
  • Fengchun Zhang
    • 2
  • Jiaming Qian
    • 1
  1. 1.Department of Gastroenterology, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
  2. 2.Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical ImmunologyMinistry of EducationBeijingChina

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