A 15-year-old girl was as having SLE concurrent with lupus cystitis since abdominal echography at onset revealed thickening of the vesical wall, increased luminescence of the renal cortex, and slight bilateral hydronephrosis. After inception of medication with prednisolone, initial symptoms and examination findings improved, but the symptoms flared up later and duodenal perforation occurred concurrently without any prodromes. However, her life was saved by an early, appropriate surgical treatment. With combined therapy of prednisolone and cyclosporine-A, the patient has followed a satisfactory clinical course up to the present.
Gastro-intestinal lesions and lupus cystitis have a similar lesional mechanism in terms of pathological features. Gastro-intestrinal lesions are said to develop simultaneous with or preceding to lupus cystitis. In the present case, lupus cystitis was found only at onset, and it improved with treatment, but there was bowel perforation so severe as to have a decisive effect on the life prognosis with the disease activity increasing. In the cases showing lupus cystitis during the clinical course, it seems necessary to make observations on the clinical course while always taking abdominal complications into consideration.
