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Hyperplastic gastropathy as a presenting manifestation of systemic lupus erythematosus

Department of Medicine, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

M Korem

Department of Medicine, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

Y Ofran

Department of Medicine, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

A Migdal

Department of Gastroenterology, Hadassah University Hospital, Ein-Kerem Campus, Jerusalem, Israel

V Doviner

Department of Pathology, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

N Hiler

Department of Radiology, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

S Aamar

Department of Medicine, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel

M Bursztyn

Department of Medicine, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel, bursz{at}cc.huji.ac.il

A patient is described who had severe hyperplastic gastropathy as the presenting manifestation of systemic lupus erythematosus (SLE). Aggressive immunosuppressive therapy with systemic corticosteroids and immunoglobulins resulted in complete remission of lupus, and a prompt clinical and radiological regression of hyperplastic gastropathy. Hyperplastic gastropathy is an uncommon gastric illness, which is usually idiopathic but rarely is associated with Helicobacter pylori infection, cytomegalovirusinfection or lymphocytic gastritis. Three previous case reports have noted a response of idiopathic hyperplastic gastropathy to systemic corticosteroid treatment, yet none of the presented patients had a systemic inflammatory disease. The presented case is the first in the medical literature in which hyperplastic gastropathy is directly linked to the development of clinical and laboratory manifestations of SLE. We suggest that hyperplastic gastropathy be added to the list of rare gastrointestinalmanifestationsof SLE, and that autoimmune disease be considereda possiblecause of hyperplastic gastropathy. As such, any patient with symptomatic idiopathic hyperplastic gastropathy accompanied by other evidence of systemic inflammation should be considered for SLE evaluation and immunosuppressive treatment.

Key Words: antiphospholipid syndrome • hyperplastic gastropathy • Menetrier • systemic lupus erythematosous

Lupus, Vol. 13, No. 1, 60-63 (2004)
DOI: 10.1191/0961203304lu465cr


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