粟粒結核治療中に急性膵炎を合併した全身性エリテマトーデス(SLE)の1剖検例

Abstract

A 59-year old woman with SLE was admitted to our hospital for the treatment of pulmonary miliary tuberculosis. She was given isoniazid and rifampicin, as an initial treatment regimen. On the 10th hospital day, she suddenly developed nausea, vomiting, diarrhea and left back pain. Furthermore, marked elevation of serum amylase level was observed. From her symptoms and laboratory findings, she was diagnosed as having acute pancreatitis and administered gabexate mesilate and antibiotics. In spite of treatment, her pancreatitis became worse gradually, and she developed respiratory distress. Methylprednisolone pulse therapy was performed, but she was complicated with pulmonary hemorrhage and died of respiratory failure. Autopsy findings suggested that acute pan- creatitis was associated with the vasculitis of SLE. To our knowledge, there have been few SLE patients complicated with acute pancreatitis, and the pathophysiology of SLE pan- creatitis is still unclear. The purpose of this paper is to discuss the relation between pancreatitis and SLE.