Abstract
A 61-year-old man with systemic lupus erythematosus (SLE) had been treated at our hospital since 2000. He had been administered 15-mg/day prednisolone therapy for more than 7 years until the dosage was reduced to 12.5 mg/day beginning in August 2010. Approximately one month later, he presented with lower abdominal pain, fever, and bloody stool. Colonoscopy revealed multiple rectal ulcers. The symptoms decreased with conservative medical treatment, and the prednisolone dose was subsequently reduced to 10 mg/day in May 2011. Lower abdominal pain, fever, and bloody stool recurred in July 2011. Colonoscopy showed multiple punched-out rectal ulcers and examination of a biopsy specimen revealed vasculitis in the ulcer beds. A diagnosis of colonic ulcers complicated with SLE was made, and the prednisolone dose was increased to 20 mg/day. Colonoscopy performed 3 months later revealed improvement in the rectal ulcers.
