Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis
American Journal of Internal Medicine
Volume 1, Issue 3, September 2013, Pages: 25-26
Received: Aug. 12, 2013;
Published: Aug. 30, 2013
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Samer Alkhuja, Department of Medicine, The Commonwealth Medical College, Pocono Medical Center, East Stroudsburg
Jonathan Goldner, Department of Medicine, The Commonwealth Medical College, Pocono Medical Center, East Stroudsburg
Systemic lupus erythematosus is a common autoimmune disorder that frequently is complicated by additional autoimmune diseases. There is a correspondence between hepatic diseases and systemic lupus erythematosus that ranges from subclinical elevations of liver enzymes to hepatic infarction. We present a rare case of portal hypertensive duodenopathy in a patient with autoimmune hepatitis/liver cirrhosis associated with systemic lupus erythematosus. Patients with systemic lupus erythematosus who present with upper gastrointestinal bleed should be evaluated for abnormal liver functions and have portal hypertensive duodenopathy included in the differential diagnosis.
Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis, American Journal of Internal Medicine.
Vol. 1, No. 3,
2013, pp. 25-26.
M.H. Miller, M.B. Urowitz, D.D Gladman, L.M. Blendis, "The liver in systemic lupus erythematosus", Q. J. Med., Summer 1984,Vol.53(211),pp.401-409.
T. Gibson, A.R. Myers, "Subclinical liver disease in systemic lupus erythematosus", J. Rheumatol., Sep-Oct 1981,Vol.8(5),pp.752-759.
V.R. Chowdhary, C.S. Crowson, J.J. Poterucha, K.A. Moder,"Liver involvement in systemic lupus erythematosus: care review of 40 patients", J. Rheumatol., Nov 2008,Vol.35(11),pp.2159-2164.
B.A. Runyon, D.R. LaBrecque, S. Anuras, "The spectrum of liver disease in systemic lupus erythematosus. Report of 33 histologically proved cases and review of the literature", Am. J. Med., Aug 1980,Vol.69(2),pp.187-194.
T. Matsumoto, T. Yoshimine, K. Shimouchi, H. Shiotu, N. Kuwabara, Y. Fukuda, T. Hoshi,"The liver in systemic lupus erythematosus: pathologic analysis of 52 cases and review of Japanese autopsy registry data", Hum Pathol., Oct 1992,Vol.23(10),pp.1151-1158.
J. Tojo, H. Ohira, K. Abe, J. Yokokawa, J. Takiguchi, T. Rai, S. Shishido, Y. Sato, R. Kasukawa, " Autoimmune hepatitis accompanied by systemic lupus erythematosus", Intern. Med., Mar 2004,Vol.43(3),pp.258-262.
D. Xu, H. Yang, C-C. Lai, P. Li, X. Zhang, X-O. Yang, F-C. Zhang, J-M. Qian,"Clinical analysis of systemic lupus erythematosus with gastrointestinal manifestations", Lupus., June 2010,Vol.19(7),pp.866-869.
S. Matsui, M. Kudo, T. Ichikawa, M. Okada, Y. Miyabe, "The clinical characteristics, endoscopic treatment, and prognosis for patients presenting with duodenal varices", Hepatogastroenterology., May-Jun 2008,Vol.55(84),pp.959-962.
N. Verbeeck, P. Stammet, J. Weber, L. Mertens, J. Se’rignol, "Bleeding duodenal varices, an unusual presentation of portal hypertension: 3D MSCT of the feeding branches facilitates temporizing treatment by percutaneous transhepatic embolization", JBR-BTR., Nov-Dec 2009,Vol.92(6),pp.289-292.
M. Okahara, H. Kiyosue, S. Ueda, J. Kashiwagi, S. Tanoue, N. Hongo, H. Mori, "Anatomic features and retrograde transvenous obliteration of duodenal varices associated with mesocaval collateral pathway", J. Vasc. Interv. Radiol., Oct 2012,Vol.23(10),pp.1339-46.