Autoimmune duodenitis and protein-losing enteropathy: An uncommon presentation of systemic lupus erythematosus

Ancasi-Medina A.I.; Calle-Herrera H.C.; Vizcarra-Vizcarra C.A.; Montesinos-Valencia L.E.; Luque-Quilla Z.; Llerena-Concha Y.A. · Revista Colombiana de Gastroenterologia (2026) · DOI: 10.22516/25007440.1510

Resumen

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that occurs more frequently in young women and affects various organs. However, gastrointestinal involvement is uncommon and may present as autoimmune duodenitis or protein-losing enteropathy, and their coexistence as the first manifestation of the disease is even more unusual. Case presentation: We present the case of a 22-year-old male patient with polyserositis, abdominal pain, diarrhea, generalized edema, hypoalbuminemia, and microcytic anemia. Endoscopy showed erosive duodenitis, and histology revealed nonspecific chronic inflammation. Immunological studies were positive for antinuclear antibodies (1:180) and other autoimmune markers, confirming the diagnosis of SLE with atypical gastrointestinal manifestations in the form of protein-losing enteropathy and autoimmune duodenitis. The patient received methylprednisolone treatment and had a favorable clinical course. Discussion: SLE has atypical gastrointestinal manifestations. Protein-losing enteropathy has a low prevalence, and its diagnosis is based on clinical findings and biopsy results. Duodenitis is more nonspecific, but finding both manifestations together in addition to an SLE diagnosis is rare. Conclusion: SLE may initially present with unusual gastrointestinal manifestations such as autoimmune duodenitis and protein-losing enteropathy in patients with generalized edema, severe hypoalbuminemia without proteinuria, and persistent anemia.

Instituciones: Universidad Católica de Santa María