Lupus enteritis and lupus cystitis share a common etiology, characterized by smooth muscle dysmotility resulting from immune complex-mediated damage. This paper describes a case of a patient presenting with concomitant lupus enteritis and lupus cystitis without a prior systemic lupus erythematosus (SLE) diagnosis. The onset of symptoms occurred five months earlier with frequent loose stools, persistent abdominal pain, nausea, vomiting, and a significant weight loss of 16 kg. The patient presented with abdominal pain, distension, dysuria, and urinary urgency lasting for a week. A computed tomography scan upon admission revealed diffuse thickening of the gastric, intestinal, and colon walls, as well as cystitis, ureteral dilation, and bilateral hydronephrosis. Extensive screening excluded infections and other autoimmune diseases, confirming SLE according to the 2019 EULAR/ACR criteria, with a high SLE disease activity index score of 18 points. Treatment with corticosteroids resulted in symptomatic improvement in the intestinal and bladder symptoms and other organ involvements. This case highlights the significance of recognizing autoimmune causes, such as lupus, in cases of widespread gastrointestinal and bladder inflammation.
Nguyen et al. (2025) studied this question.