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A Rare Initial Manifestation of Systemic Lupus Erythematosus—Acute Pancreatitis: Case Report and Review of the Literature

From the Family Practice Residency (HVD), and the Department of Family Practice (GA), State University of New York, Brooklyn. Address reprint requests to Gloria Achara, MD, Department of Family Practice, State University of New York, HSC-B, Box 67, 450 Clarkson Ave, Brooklyn, NY 11203

Background: Acute pancreatitis as the initial manifestation of systemic lupus erythematosus (SLE) has been documented only nine times in the English literature.

Methods: We report the case of a 25-year-old woman patient with fever, abdominal pain and vomiting, elevated levels of pancreatic enzymes, and various other laboratory abnormalities. Further investigation led to a diagnosis of SLE. A literature search, using the key words "systemic lupus erythematosus" and "pancreatitis" was undertaken.

Results and Conclusions: The treatment of SLE pancreatitis is steroids, which is somewhat controversial because steroids have been implicated in the cause. SLE can involve any organ system. It is important that the family physician, who treats patients as a whole, rules out SLE when a straightforward diagnosis is associated with inexplicable multiple concomitant abnormalities.