Successful treatment of massive ascites due to lupus peritonitis with hydroxychloroquine in old- onset lupus erythematosus.
Identifieur interne : 001005 ( Main/Exploration ); précédent : 001004; suivant : 001006Successful treatment of massive ascites due to lupus peritonitis with hydroxychloroquine in old- onset lupus erythematosus.
Auteurs : Sonia Hammami [Tunisie] ; Fethia Bdioui [Tunisie] ; Afef Ouaz [Tunisie] ; Hichem Loghmari [Tunisie] ; Sylvia Mahjoub [Tunisie] ; Hamouda Saffar [Tunisie]Source :
- The Pan African medical journal [ 1937-8688 ] ; 2014.
Descripteurs français
- KwdFr :
- Ascites (anatomopathologie), Ascites (traitement médicamenteux), Ascites (étiologie), Femelle, Humains, Hydroxychloroquine (usage thérapeutique), Lupus érythémateux disséminé (), Péritonite (anatomopathologie), Péritonite (traitement médicamenteux), Péritonite (étiologie), Résultat thérapeutique, Sujet âgé, Tunisie, Âge de début.
- MESH :
- anatomopathologie : Ascites, Péritonite.
- traitement médicamenteux : Ascites, Péritonite.
- usage thérapeutique : Hydroxychloroquine.
- étiologie : Ascites, Péritonite.
- Femelle, Humains, Lupus érythémateux disséminé, Résultat thérapeutique, Sujet âgé, Tunisie, Âge de début.
- Wicri :
- geographic : Tunisie.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Hydroxychloroquine.
- geographic : Tunisia.
- complications : Lupus Erythematosus, Systemic.
- drug therapy : Ascites, Peritonitis.
- etiology : Ascites, Peritonitis.
- pathology : Ascites, Peritonitis.
- Age of Onset, Aged, Female, Humans, Treatment Outcome.
Abstract
Systemic lupus erythematous (SLE) is an auto-immune disease with multiple organ involvements that occurs mainly in young women. Literature data suggest that serositis is more frequent in late-onset SLE. However, peritoneal serositis with massive ascites is an extremely rare manifestation. We report a case of old-onset lupus peritonitis treated successfully by Hydroxychloroquine. A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis. Physical examination showed only massive ascites. Laboratory investigations showed leucopenia: 3100/mm3, lymphopenia: 840/mm3 and trace protein (0.03 g/24 h). Ascitic fluid contained 170 cells mm(3) (67% lymphocytes), 46 g/L protein, but no malignant cells. The main etiologies of exudative ascites were excluded. She had markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL) with hypo-complementemia (C3 levl was at 67 mg/dL). Antibody against the Smith antigen was also positive. Relying on these findings, the patient was diagnosed with SLE and treated with Hydroxychloroquine 200 mg daily in combination with diuretics. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take chloroquine. This case was characterized by old age of onset of SLE, the extremely rare initial presentation with lupus peritonitis and massive painful ascites with dramatic response to only hydroxychloroquine treatment.
DOI: 10.11604/pamj.2014.18.165.2080
PubMed: 25422683
Affiliations:
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Hospital, Monastir</wicri:regionArea><wicri:noRegion>Monastir</wicri:noRegion></affiliation></author><author><name sortKey="Bdioui, Fethia" sort="Bdioui, Fethia" uniqKey="Bdioui F" first="Fethia" last="Bdioui">Fethia Bdioui</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hepathology and Gastroenterology, Fattouma Bourguiba Universitary Hospital, Monastir, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of Hepathology and Gastroenterology, Fattouma Bourguiba Universitary Hospital, Monastir</wicri:regionArea><wicri:noRegion>Monastir</wicri:noRegion></affiliation></author><author><name sortKey="Ouaz, Afef" sort="Ouaz, Afef" uniqKey="Ouaz A" first="Afef" last="Ouaz">Afef Ouaz</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hepathology and Gastroenterology, Fattouma Bourguiba Universitary Hospital, Monastir, Tunisia.</nlm:affiliation><country xml:lang="fr">Tunisie</country><wicri:regionArea>Department of 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qualifier="traitement médicamenteux" xml:lang="fr"><term>Ascites</term><term>Péritonite</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Ascites</term><term>Péritonite</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age of Onset</term><term>Aged</term><term>Female</term><term>Humans</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Femelle</term><term>Humains</term><term>Lupus érythémateux disséminé</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tunisie</term><term>Âge de début</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Tunisie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Systemic lupus erythematous (SLE) is an auto-immune disease with multiple organ involvements that occurs mainly in young women. Literature data suggest that serositis is more frequent in late-onset SLE. However, peritoneal serositis with massive ascites is an extremely rare manifestation. We report a case of old-onset lupus peritonitis treated successfully by Hydroxychloroquine. A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis. Physical examination showed only massive ascites. Laboratory investigations showed leucopenia: 3100/mm3, lymphopenia: 840/mm3 and trace protein (0.03 g/24 h). Ascitic fluid contained 170 cells mm(3) (67% lymphocytes), 46 g/L protein, but no malignant cells. The main etiologies of exudative ascites were excluded. She had markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL) with hypo-complementemia (C3 levl was at 67 mg/dL). Antibody against the Smith antigen was also positive. Relying on these findings, the patient was diagnosed with SLE and treated with Hydroxychloroquine 200 mg daily in combination with diuretics. One month later, there was no detectable ascitic fluid and no pleural effusions. Five months later she remained free from symptoms while continuing to take chloroquine. This case was characterized by old age of onset of SLE, the extremely rare initial presentation with lupus peritonitis and massive painful ascites with dramatic response to only hydroxychloroquine treatment.</div></front></TEI><affiliations><list><country><li>Tunisie</li></country></list><tree><country name="Tunisie"><noRegion><name sortKey="Hammami, Sonia" sort="Hammami, Sonia" uniqKey="Hammami S" first="Sonia" last="Hammami">Sonia Hammami</name></noRegion><name sortKey="Bdioui, Fethia" sort="Bdioui, Fethia" uniqKey="Bdioui F" first="Fethia" last="Bdioui">Fethia Bdioui</name><name sortKey="Loghmari, Hichem" sort="Loghmari, Hichem" uniqKey="Loghmari H" first="Hichem" last="Loghmari">Hichem Loghmari</name><name sortKey="Mahjoub, Sylvia" sort="Mahjoub, Sylvia" uniqKey="Mahjoub S" first="Sylvia" last="Mahjoub">Sylvia Mahjoub</name><name sortKey="Ouaz, Afef" sort="Ouaz, Afef" uniqKey="Ouaz A" first="Afef" last="Ouaz">Afef Ouaz</name><name sortKey="Saffar, Hamouda" sort="Saffar, Hamouda" uniqKey="Saffar H" first="Hamouda" last="Saffar">Hamouda Saffar</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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