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Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis

Received: 12 August 2013     Published: 30 August 2013
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Abstract

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.

Published in American Journal of Internal Medicine (Volume 1, Issue 3)
DOI 10.11648/j.ajim.20130103.11
Page(s) 25-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Shock, Lupus, Liver Cirrhosis, GI Bleed

References
[1] 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.
[2] T. Gibson, A.R. Myers, "Subclinical liver disease in systemic lupus erythematosus", J. Rheumatol., Sep-Oct 1981,Vol.8(5),pp.752-759.
[3] 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.
[4] 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.
[5] 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.
[6] 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.
[7] 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.
[8] 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.
[9] 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.
[10] 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.
Cite This Article
  • APA Style

    Samer Alkhuja, Jonathan Goldner. (2013). Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis. American Journal of Internal Medicine, 1(3), 25-26. https://doi.org/10.11648/j.ajim.20130103.11

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    ACS Style

    Samer Alkhuja; Jonathan Goldner. Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis. Am. J. Intern. Med. 2013, 1(3), 25-26. doi: 10.11648/j.ajim.20130103.11

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    AMA Style

    Samer Alkhuja, Jonathan Goldner. Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis. Am J Intern Med. 2013;1(3):25-26. doi: 10.11648/j.ajim.20130103.11

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  • @article{10.11648/j.ajim.20130103.11,
      author = {Samer Alkhuja and Jonathan Goldner},
      title = {Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis},
      journal = {American Journal of Internal Medicine},
      volume = {1},
      number = {3},
      pages = {25-26},
      doi = {10.11648/j.ajim.20130103.11},
      url = {https://doi.org/10.11648/j.ajim.20130103.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20130103.11},
      abstract = {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.},
     year = {2013}
    }
    

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    T1  - Hemorrhagic Shock Secondary to Portal Hypertensive Duodenopathy Complicated By Lupus and Autoimmune Liver Cirrhosis
    AU  - Samer Alkhuja
    AU  - Jonathan Goldner
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    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    SN  - 2330-4324
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    AB  - 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.
    VL  - 1
    IS  - 3
    ER  - 

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Author Information
  • Department of Medicine, The Commonwealth Medical College, Pocono Medical Center, East Stroudsburg

  • Department of Medicine, The Commonwealth Medical College, Pocono Medical Center, East Stroudsburg

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