Pediatric Nephrology

, Volume 21, Issue 6, pp 873–876

Acute acalculous cholecystitis in a child with systemic lupus erythematosus

  • Mitra Basiratnia
  • Mohammad Vasei
  • Ali Bahador
  • Esmaeel Ebrahimi
  • Ali Derakhshan
Brief Report


A 10-year-old boy with systemic lupus erythematosus (SLE) developed abrupt right upper quadrant pain and vomiting during the course of his active disease. Antiphospholipid antibody was negative and the C3 level was low. Abdominal sonography showed cholecystitis with sludge balls in the gallbladder. He was treated by high-dose prednisolone with ceftriaxone and metronidazole IV for 3 days but due to poor response, cholecystectomy was performed and no stone was identified. Histopathologic examination showed vasculitis in the medium-sized arteries of the gallbladder wall. He was doing well at the 9-month follow-up after the operation. This report describes the first pediatric case of SLE with acalculous cholecystitis caused by vasculitis of the gallbladder.


Systemic lupus erythematosus Vasculitis Acalculous cholecystitis 


  1. 1.
    Avner ED, Harmon WE, Niandet P (2004) Systemic lupus erythematosus. In: Niaudet P, Salomon R (eds) Pediatric nephrology. Williams & Wilkins, Philadelphia, pp 865–880Google Scholar
  2. 2.
    Shin SJ, Na KS, Jung SS, Bae SC, Yoo DH, Kim SY, Kim TH (2002) Acute acalculous cholecystitis associated with systemic lupus erythematosus with Sjogren’s syndrome. Korean J Intern Med 17:61–64PubMedGoogle Scholar
  3. 3.
    Kamimura T, Mimori A, Takeda A, Masuyama J, Yoshio T, Okazaki H, Kano S, Minota S (1998) Acute acalculous cholecystitis in systemic lupus erythematosus: a case report and review of the literature. Lupus 7:361–363PubMedCrossRefGoogle Scholar
  4. 4.
    Suwa A, Hama N, Kawai S, Ishiyama K, Tanabe M, Yamada T, Goto M, Nakajima A, Kashiwazaki S, Inada S (1995) A case of Sjogren’s syndrome and systemic lupus erythematosus complicated with necrotizing angiitis of the gallbladder. Ryumachi 35:904–909PubMedGoogle Scholar
  5. 5.
    Rhoton AJ, Gilliam JH, Geisinger KR (1993) Hemobilia in systemic lupus erythematosus. South Med J 86:1049–1051PubMedGoogle Scholar
  6. 6.
    Martinez D, Lowe R (1991) Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis. Clin Radiol 44:434–435PubMedCrossRefGoogle Scholar
  7. 7.
    Raijman L, Schrager M (1998) Hemorrhagic acalculous cholecystitis in systemic lupus erythematosus. Am J Gastroenterol 84:445–447Google Scholar
  8. 8.
    Newbold KM, Allum WH, Downing R, Symmons DP, Oates GD (1987) Vasculitis of the gall bladder in rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 6:287–289PubMedCrossRefGoogle Scholar
  9. 9.
    Swanepoel CR, Floyd A, Allison H, Learmonth GM, Cassidy MJ, Pascoe MD (1983) Acute acalculous cholecystitis complicating systemic lupus erythematosus: case report and review. Br Med J Clin (Clin Res Ed) 286:251–252Google Scholar
  10. 10.
    Bando H, Kobayashi S, Matsumoto T, Tamura N, Yamanaka K, Yamaji C, Takasaki C, Takasaki Y, Hashimoto H (2003) Acute acalculous cholecystitis induced by mesenteric inflammatory veno-occlusive disease (MIVOD) in systemic lupus erythematosus. Clin Rheumatol 22:447–449PubMedCrossRefGoogle Scholar
  11. 11.
    Lee CK, Ahn MS, Lee EY, Shin JH, Cho YS, Ha HK, Yoo B, Moon HB (2002) Acute abdominal pain in systemic lupus erythematosus: focus on lupus enteritis (gastrointestinal vasculitis). Ann Rheum Dis 61:547–550PubMedCrossRefGoogle Scholar
  12. 12.
    Daly SS, Galloway F (1999) Gallbladder and extrahepatic biliary system. In: Schwartz SI (ed) Principles of surgery. McGraw-Hill, New York, pp 1437–1466Google Scholar
  13. 13.
    Warren BL (1992) Small vessel occlusion in acute acalculous cholecystitis. Surgery 111:163–168PubMedGoogle Scholar
  14. 14.
    Mc Gaham JP, Goldberg BB (1998) Gall bladder and bile ducts. In: Parulekar SG (ed) Diagnostic ultrasound. Lippincott-Raven, Philadelphia, pp 693–759Google Scholar
  15. 15.
    Dessailloud R, Papo T, Vaneecloo S, Gamblin C, Vanhille P, Piette JC (1998) Acalculous ischemic gallbladder necrosis in the catastrophic antiphospholipid syndrome. Arthritis Rheum 41:1318–1320PubMedCrossRefGoogle Scholar
  16. 16.
    Nolen N, Bellaiche G, Warmberg C, Nouts A, Ley G, Slama JL (1999) Acute acalculous cholecystitis associated with primary antiphospholipid antibody syndrome. Cure with low-molecular-weight heparin and antivitamin K. Gastroenterol Clin Biol 23:144–146PubMedGoogle Scholar

Copyright information

© IPNA 2006

Authors and Affiliations

  • Mitra Basiratnia
    • 1
  • Mohammad Vasei
    • 2
  • Ali Bahador
    • 3
  • Esmaeel Ebrahimi
    • 2
  • Ali Derakhshan
    • 1
  1. 1.Department of Pediatric Nephrology, Nemazee HospitalShiraz Medical SchoolShirazIran
  2. 2.Department of Pathology and Institute of Cancer ResearchShiraz Medical SchoolShirazIran
  3. 3.Department of Pediatric surgery, Nemazee hospitalShiraz Medical SchoolShirazIran

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