J Rheum Dis.  2014 Jun;21(3):140-142. 10.4078/jrd.2014.21.3.140.

A Case of Systemic Lupus Erythematosus Initially Presented with Acute Acalculous Cholecystitis

• Choi YJ
• Yoon HY
• Jang SA
• Hong MJ
• Lee WS
• Yoo WH

• KMID: 2297525
• DOI: http://doi.org/10.4078/jrd.2014.21.3.140

Abstract

SLE is an autoimmune disease with multiorgan involvement and a wide range of clinical manifestations, and inflammation of gallbladder also can be represented. There were a few cases of acute acalculous cholecystitis (AAC) in previous reports. Most of them tended to already know about underlying SLE when detected AAC at that time. It may be difficult to detect AAC caused by SLE not due to biliary stone if physician is not conscious of undiagnosed lupus. We introduce a 70-year old female patient, who is diagnosed with AAC. Her symptoms were satisfied the ACR classification criteria for SLE, and was diagnosed with SLE, simultaneously. After a high dose steroid pulse therapy, followed by cyclophosphamide, her symptoms have improved rapidly. In order to better diagnose and treat the disease, we need to be aware of AAC as a potential manifestation of SLE.

Keyword

Lupus; Cholecystitis

MeSH Terms

Acalculous Cholecystitis*
Autoimmune Diseases
Cholecystitis
Classification
Cyclophosphamide
Female
Gallbladder
Humans
Inflammation
Lupus Erythematosus, Systemic*
Cyclophosphamide

Figure

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  Figure 1. The abdominal CT shows gall bladder distension with mild wall thickening without visible stone.

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  Figure 2. The patient has revealed malar rash on her cheeks on the course of the disease.

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