SLE-associated intestinal pseudo-obstruction: a case report and analysis of 43 cases

20 Apr 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

IntroductionIntestinal pseudo-obstruction (IPO) is a rare but serious gastrointestinal complication of systemic lupus erythematosus (SLE), often mimicking surgical obstruction. It may be reversible with prompt immunosuppressive therapy but is frequently misdiagnosed. Methods. We report a patient with SLE-IPO and a history of pulmonary arterial hypertension (PAH), a combination rarely described. A systematic review was conducted via PubMed and EMBASE through March 31, 2025.
After deduplication and screening, 30 publications reporting 42 individual cases were included. Combined with our case, 43 cases were analyzed. Clinical characteristics, treatments, and outcomes were extracted and compared by publication date (≤2010 vs. >2010).Results. Among the 43 patients, 93.02% were female, with a median age of 32.00 years.
IPO was the initial SLE presentation in 62.79%, and more than 90.00% occurred during active disease. Genitourinary involvement was present in 46.51%. All patients received corticosteroids. Cyclophosphamide was used in 37.21%, IVIG in 18.60%, MMF in 16.28%, and rituximab in 4.65%. After 2010, IVIG use increased (32.00% vs.
0.00%), along with broader use of MMF and biologics. IPO relapsed in 39.53%; mortality was low (2.33%).