Lupus And Crohn's Disease Connection.


In November 2020, I went into a bad Lupus flare, this flare was not like the other flare's that I had been accustomed to going into. The warning signs were the same, oral ulcers, nasal ulcers and yes the butterfly rash started to appear. The only concern that was somewhat of a concern at this time is, could it be COVID-19, but with me I always have a low grade fever, so I monitored my temperature closely throughout the flare.


The intensity of the pain was none that I have ever felt before, the pain is truly indescribable. At this point all I could do was to deal with it and pray to God that He would give me some relief, and he did. If you are wondering if I'm on any medications to control the symptoms of lupus the answer is "No". I was on Hydroxychloroquine for approximately fourteen years (14) and this medication was causing more harm to my body than good, I am currently unable to take any medications to control the symptoms for lupus. Now as I stated previously this flare was totally different, this time I had develop new symptoms: Nausea, Diarrhea, loss of appetite, headaches, upper right quadrant abdominal pain, bloating.


The first thought that came to mind was lupus has attacked my liver once again, but then I started to feel lower pain in my back which would represent a problem with my kidney, and finally I stated that lupus is attacking all of my internal organs and especially my bowels. And with all this going on it was time for me to make the round with the gastroenterologist. I have a litany of test that I'm currently going through to rule out a number of diagnosis and especially pancreatic cancer.


I posed a question to my gastroenterologist "Since lupus attacks my internal organs, is there a possibility that lupus has attacked my bowels, and that I may have Crohn's Disease"? "The doctor stated yes, she believes that this just maybe Crohn's Disease, but we are going to have to rule out everything even pancreatic cancer first".


Yes, there is a common genetic link between Crohn's and Lupus and many other autoimmune diseases. Those who are diagnosed with both need to make sure that their gastrointestinal symptoms are not from Gastroenteric Lupus...it can be difficult to tell them apart. Systemic lupus erythematosus (SLE) is a chronic and serious autoimmune disease, characterized by erythema discus, myalgia and arthralgias. It is a multisystem disease and can induce renal, digestive, neurologic and hematologic disorders.


SLE tends to occur primarily in women aged 15–44. Gastrointestinal involvement in SLE appears almost regular. The digestive system is reported to be involved in 8–40% of patients with lupus and up to 53% of patients with SLE develop lupus enteritis [1]. Lupus enteritis is a disease of lupus that affects a wide range of intestinal tract. Lupus mesenteric vasculitis, protein-losing enteropathy and intestinal pseudo-obstruction (IPO) are collectively known as lupus enteritis.


Crohn’s disease is a chronic intestinal granulomatous disease with unknown etiology. It tends to occur in young people around 30 years old and old people around 60 years old. It is characterized by abdominal pain, diarrhea, constipation and repeated intestinal obstruction. The lesion site is usually located in the ileum and colon. Many patients with Crohn’s disease; however, still suffer from extraintestinal manifestations, including arthritis, spondylitis, sacroiliitis and erythema nodosum.


The differentiation between Crohn’s disease and lupus enteritis is difficult because both the two diseases can show similar clinical signs and symptoms such as abdominal pain, bloating, intestinal obstruction and so on. In addition, it is known that coexistence of SLE and Crohn’s disease is very rare. Crohn’s disease may occur before or after the diagnosis of SLE, but Crohn’s disease prior to lupus is commonly seen in drug-induced cases during Crohn’s disease treatment. Crohn’s disease’s presence after SLE is extremely rare.


Resource

European Journal Of Gastroenterology (2020) Coexistence of Crohn’s disease and systemic lupus erythematosus: a case report and literature reviewJin, Xiaoronga,,*; Wang, Guib,,c,,*; Xu, Xiaohuaa; Bai, Yunjinga; An, Rand; Jiang, DexunaAuthor InformationEuropean Journal of Gastroenterology & Hepatology: September 2020 - Volume 32 - Issue 9 - p 1256-1262doi: 10.1097/MEG.0000000000001775

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