Korean J Med.  2012 Feb;82(2):252-256.

A Case of Systemic Lupus Erythematosus Presenting as a Large Rectosigmoid Ulcer

• Yoo IK
• Yoo SH
• Choi S
• Koo JS
• Lee Y
• Ji J
• Song K

Abstract

Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder that has many symptoms. Gastrointestinal symptoms are common, while colonic involvement in the form of ischemic colitis or a colonic ulcer is rare in SLE. The differential diagnosis of ischemic proctitis with ulceration includes an infected ulcer, ulcerative colitis, Crohn's disease, solitary rectal ulcer colitis, malignant tumor, and lupus colitis. Here, we report a 22-year-old male with abdominal pain and diarrhea, who had a huge rectal ulcer that nearly obstructed the rectosigmoid junction. This turned out to be a rare gastrointestinal manifestation of lupus. He recovered after being treated with high-dose oral steroids. Our case demonstrates that a rectal ulcer is a rare, but important, complication of SLE and can be the initial clinical manifestation of the disease.

Keyword

Systemic lupus erythematosus; Proctitis; Ischemic colitis

MeSH Terms

Abdominal Pain
Colitis
Colitis, Ischemic
Colitis, Ulcerative
Colon
Crohn Disease
Diagnosis, Differential
Diarrhea
Humans
Lupus Erythematosus, Systemic
Male
Proctitis
Steroids
Ulcer
Young Adult
Steroids