A paediatric systemic lupus erythematosus patient presenting with acute pancreatitis: a rare case

Systemic lupus erythematosus (SLE) is a disease associated with widely varying clinical presentations characterised by multisystem involvement. While gastrointestinal involvement is known as a very common situation, acute pancreatitis is a rare condition [1]. Systemic lupus erythematosus cases with acute pancreatitis have rarely been described in the medical literature [2].
The aim of the current study is to present a paediatric patient with SLE, who presented at our clinic after developing acute pancreatitis.
The patient was a 3-year-old girl who was admitted to the clinical centre with the symptoms of fever, stomach ache, fatigue, facial and eye flushing, and swelling in both ankles. The swelling in both ankles was persistent over the previous month. In the 15 days prior to presentation at our clinic, the patient had fever, stomach ache, asthaenia, and facial and eye rubor. Although her family’s medical history indicated that one of her siblings had a neuromotor development disorder, the patient’s medical history was unremarkable. Upon physical examination, the patient weighed 12 kg (10–25th percentile) and her height was 97 cm (50th percentile). She had conjunctivitis and malar rush in both eyes, sensitivity at the epigastric area in the right upper quadrant, and arthritis in both ankles. Laboratory data of the patient were as follows: haemoglobin (HB) 7.8 g/dl (N: 9–11), leucocyte (WBC) 2110/mm3 (N: 4.8–10.8), lymphocyte 600/mm3 (N: 1.2–3.5), thrombocyte (PLT) 195000/µl (N: 150 000–450 000), alanine aminotransferase (ALT) 235 U/l (N: 0–41), aspartate aminotransferase (AST) 312 U/l (N: 0–40), -glutamyl transferase (GGT) 243 U/l (N: 10–61), total bilirubin (T. Bil) 4.7 mg/dl (N: 0.1–1.2), direct bilirubin (D. Bil) 3.9 mg/dl (N: 0–0.2), prothrombin time (PT) 11.8 sn (N: 11–14), INR 1.05 (N: 0.9–1.2), active partial thrombin time (aPTT) 28.2 sn (N: 25–33), lipase 1291 U/l (N: 13–60), pancreatic amylase 541 U/l (N: 13–53), sedimentation 76 mm/h (N: 0–20), total protein 5.9 g/dl, and albumin 3.86 g/dl (N: 3.5–5). Serum electrolytes, kidney function tests, coagulation, lipid profile test, and peripheral smear tests were all normal. Protein (+), ketone (++), and bilirubin (+) were found in urinalysis. The stool tests were negative for pathologic findings. Minimal liquor in the peripancreatic area and oedema in pancreas were observed during abdominal ultrasonography. The patient was diagnosed with acute pancreatitis and oral feeding was ceased....


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