Skip to main content
Log in

Systemic lupus erythematosus-related pancreatitis in children

  • Case Based Review
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

We report on three patients who developed four episodes of acute pancreatitis while their systemic lupus erythematosus was active and being treated with prednisolone. In all three, gastritis was first considered and treated due to abdominal pain, vomiting, and epigastric tenderness, but their symptoms did not improve. Then pancreatic enzymes were measured, which confirmed pancreatitis. Imaging studies showed an enlarged pancreas in one case, a normal pancreas in two cases, and a focal hypodense nonenhancing parenchyma in one case. Corticosteroids were prescribed for both active SLE and SLE-related pancreatitis. Pulse methylprednisolone was prescribed in one episode, increasing oral prednisolone in one episode, and the same dose of prednisolone continued in the other two episodes. All cases recovered without complications. SLE-related pancreatitis should be considered in SLE patients when the SLE is active and a patient develops abdominal pain and vomiting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ranson JH (1997) Diagnostic standards for acute pancreatitis. World J Surg 21:136–142

    Article  PubMed  CAS  Google Scholar 

  2. Makol A, Petri M (2010) Pancreatitis in systemic lupus erythematosus: frequency and associated factors - a review of the Hopkins Lupus Cohort. J Rheumatol 37:341–345

    Article  PubMed  Google Scholar 

  3. Lariño Noia J, Macías García F, Seijo Ríos S, Iglesias García J, Domínguez Muñoz JE (2009) Pancreatitis and systemic lupus erythematosus. Rev Esp Enferm Dig 101:571–579

    Article  PubMed  Google Scholar 

  4. Pascual-Ramos V, Duarte-Rojo A, Villa AR, Hernández-Cruz B, Alarcón-Segovia D, Alcocer-Varela J, Robles-Díaz G (2004) Systemic lupus erythematosus as a cause and prognostic factor of acute pancreatitis. J Rheumatol 31:707–712

    PubMed  Google Scholar 

  5. Derk CT, DeHoratius RJ (2004) Systemic lupus erythematosus and acute pancreatitis: a case series. Clin Rheumatol 23:147–151

    Article  PubMed  Google Scholar 

  6. Saab S, Corr MP, Weisman MH (1998) Corticosteroids and systemic lupus erythematosus pancreatitis: a case series. J Rheumatol 25:801–806

    PubMed  CAS  Google Scholar 

  7. Kapoor D, Mendez E, Espinoza LR (1999) Corticosteroids and SLE pancreatitis. J Rheumatol 26:1011–1012

    PubMed  CAS  Google Scholar 

  8. Tian XP, Zhang X (2010) Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis, and treatment. World J Gastroenterol 16:2971–2977

    Article  PubMed  CAS  Google Scholar 

  9. Breuer GS, Baer A, Dahan D, Nesher G (2006) Lupus-associated pancreatitis. Autoimmun Rev 5:314–318

    Article  PubMed  Google Scholar 

  10. Richer O, Ulinski T, Lemelle I, Ranchin B, Loirat C, Piette JC, Pillet P, Quartier P, Salomon R, Bader-Meunier B, French Pediatric-Onset SLE Study Group (2007) Abdominal manifestations in childhood-onset systemic lupus erythematosus. Ann Rheum Dis 66:174–178

    Article  PubMed  CAS  Google Scholar 

  11. Riemenschneider TA, Wilson JF, Vernier RL (1968) Glucocorticoid-induced pancreatitis in children. Pediatrics 41:428–443

    PubMed  CAS  Google Scholar 

  12. Kobayashi S, Yoshida M, Kitahara T, Abe Y, Tsuchida A, Nojima Y (2007) Autoimmune pancreatitis as the initial presentation of systemic lupus erythematosus. Lupus 16:133–136

    Article  PubMed  CAS  Google Scholar 

  13. Essaadouni L, Samar E, Krati K (2010) Pancreatitis as initial manifestation of systemic lupus erythematosus. Lupus 19:884–887

    Article  PubMed  CAS  Google Scholar 

  14. Perrin L, Giurgea I, Baudet-Bonneville V, Deschênes G, Bensman A, Ulinski T (2006) Acute pancreatitis in pediatric systemic lupus erythematosus. Acta Paediatr 95:121–124

    Article  PubMed  Google Scholar 

  15. Goldberg BH, Bergstein JM (1978) Acute respiratory distress in a child after steroid-induced pancreatitis. Pediatrics 61:317–318

    PubMed  CAS  Google Scholar 

  16. Reynolds JC, Inman RD, Kimberly RP, Chuong JH, Kovacs JE, Walsh MB (1982) Acute pancreatitis in systemic lupus erythematosus: report of 20 cases and a review of the literature. Medicine (Baltimore) 61:25–32

    CAS  Google Scholar 

  17. Simons-Ling N, Schachner L, Penneys N, Gorman H, Zillereulo G, Strauss J (1983) Childhood systemic lupus erythematosus. Association with pancreatitis, subcutaneous fat necrosis, and calcinosis cutis. Arch Dermatol 119:491–494

    Article  PubMed  CAS  Google Scholar 

  18. Garcia-Consuegra J, Merino R, Alonso A, Goded F (1992) Systemic lupus erythematosus: a case report with unusual manifestations and favorable outcome after plasmapheresis. Eur J Pediatr 151:581–582

    Article  PubMed  CAS  Google Scholar 

  19. Ramanan AV, Thimmarayappa AD, Baildam EM (2002) Acute lethal pancreatitis in childhood systemic lupus erythematosus. Rheumatology (Oxford) 41:467–469

    Article  CAS  Google Scholar 

  20. Fan HC, Cheng SN, Hua YM, Chu CH, Juan CJ, Lee MY, Hung CH (2003) Systemic lupus erythematosus-related acute pancreatitis: a case report. J Microbiol Immunol Infect 36:212–214

    PubMed  Google Scholar 

  21. Penalva JC, Martinez J, Pascual E, Palanca VM, Lluis F, Peiró F, Pérez H, Pérez-Mateo M (2003) Chronic pancreatitis associated with systemic lupus erythematosus in a young girl. Pancreas 27:275–277

    Article  PubMed  CAS  Google Scholar 

  22. Rose W, Puliyel MM, Moses PD, Danda D (2009) Acute pancreatitis as the initial presentation in pediatric systemic lupus erythematosus. Indian J Pediatr 76:846–847

    Article  PubMed  Google Scholar 

  23. Nesher G, Breuer GS, Temprano K, Moore TL, Dahan D, Baer A, Alberton J, Izbicki G, Hersch M (2006) Lupus-associated pancreatitis. Semin Arthritis Rheum 35:260–267

    Article  PubMed  Google Scholar 

Download references

Disclosures

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Prayong Vachvanichsanong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Limwattana, S., Dissaneewate, P., Kritsaneepaiboon, S. et al. Systemic lupus erythematosus-related pancreatitis in children. Clin Rheumatol 32, 913–918 (2013). https://doi.org/10.1007/s10067-013-2242-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-013-2242-2

Keywords

Navigation