8-year history of lupus, high fever does not subside for 2 days because of this complication

Source: SLE Jieyou grocery store


Patient situation:

Male, 25 years old.

SLE condition:

8 years history of SLE, lupus nephritis III(A)+V.

Currently taking methylprednisolone 8mg and hydroxychloroquine 0.4g orally every day.

Seeing symptoms:

Fever for 2 days, body temperature up to 40°C. Consultation on February 23, 2020.

Examination results:

Body temperature 39.5°C, blood pressure 87/41mmHg

abnormal liver function, decreased complement C3 and C4

ANA Titer(+)

Anti-nRNP/SM antibody(+), anti-SM antibody(+), anti-SSA antibody(+), anti-double-stranded DNA antibody were negative

pulmonary CT showed: bilateral upper lobe paraseptal emphysema

After treatment:

After admission, anti-infection, blood pressure boosting, fluid replacement and other treatments were given, and the condition improved.

On the 3rd day of admission, he developed epigastric pain and nausea. Check for elevated amylase, consider acute pancreatitis.

After symptomatic treatment, the abdominal pain improved slightly.

On the 4th day, the amylase increased sharply, and hormones were added.

On the 7th day, the symptoms of abdominal pain were relieved and she was discharged from hospital.

Condition after discharge:

Follow-up after discharge, there was no recurrence of abdominal pain.

Acute pancreatitis

Acute pancreatitis is an inflammatory reaction of pancreatic tissue autodigestion, edema, hemorrhage and even necrosis caused by the activation of pancreatic enzymes in the pancreas. about 10%. Divided into edema type and hemorrhagic necrosis type, the main symptoms are: abdominal pain, nausea, vomiting, fever, and even shock, high fever and so on. Common causes of pancreatitis: biliary tract disease, hyperlipidemia, alcoholism, etc.

SLE and pancreatitis

The incidence of pancreatitis in SLE has been reported differently. 30.5% of SLE patients had hyperamylase without symptoms of pancreatitis. SLE with pancreatitis predicts increased mortality. Infection is associated with systemic lupus erythematosus with pancreatitis. SLE patients taking hormones, azathioprine and other special drugs are at high risk of acute pancreatitis.

Prevention of pancreatitis

1. Reasonable diet

Overeating is currently recognized as one of the causes of acute pancreatitis, especially eating foods containing a lot of fat. food and alcohol.

2. Actively treat hyperlipidemia and hypercalcemia and other diseases

3. Early treatment of biliary tract disease

4. Regular work and rest, avoid staying up late< /p>

5. Appropriate exercise

6. Seek medical attention in time

If there are incentives such as heavy drinking, overeating, and severe pain in the left upper quadrant or upper abdomen, or Fever, nausea, vomiting, etc., be sure to seek medical attention in time!

Review: Hu Haiyan