Clinical Report: Concurrent Visceral Vasculitis Manifestations in SLE

Overview

This case study presents a 16-year-old girl with Systemic Lupus Erythematosus (SLE) who exhibited concurrent lupus enteritis and ureteritis. The diagnosis was confirmed through imaging and laboratory findings.

Background

Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease that can affect multiple organ systems, including the gastrointestinal and urinary tracts. While lupus enteritis is a recognized manifestation, lupus ureteritis is rare, making simultaneous occurrences challenging to diagnose.

Data Highlights

Key laboratory findings included a high CRP/low PCT dissociation and a markedly elevated D-Dimer (13.74 μg/mL). Imaging revealed distinct ureteral wall enhancement on CECT.

Key Findings

• The patient had a history of transient ptosis and positive ANA/dsDNA results prior to the current presentation.
• Initial CT showed bilateral hydroureteronephrosis.
• CECT demonstrated the classic 'target sign' in the bowel wall and splenic infarction.
• The patient received methylprednisolone pulse therapy and IVIG.
• Maintenance therapy included Cyclophosphamide and Telitacicept.

Clinical Implications

Recognizing ureteral wall enhancement on CECT may aid in diagnosing primary lupus ureteritis.

Conclusion

This case highlights the distinction between primary and secondary urinary tract involvement in SLE.

Related Resources & Content

1. Clinical Rheumatology, 2025 -- Management and Long-Term Outcomes in Children with Hypocomplementemic Urticarial Vasculitis Syndrome (HUVS): A Review of Case Studies
2. Clinical Rheumatology, 2025 -- Chimeric Antigen Receptor T Cell Therapy for Pediatric Systemic Lupus Erythematosus
3. Frontiers in Pediatrics, 2026 -- Childhood-onset systemic lupus erythematosus presenting with growth retardation and delayed puberty: a case report
4. Retinal Physician — UVEITIS CORNER: Current Management of Pediatric Uveitis
5. Guidance on SLE Management
6. Gastrointestinal manifestations of systemic lupus erythematosus (SLE): A comprehensive literature review