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文献考察１）：ループス腸炎
【全身性疾患と消化管病変】 膠原病,免疫・アレルギー性疾患 全身性エリテマトーデス(systemic lupus erythematosus;SLE)
Author：城由起彦(九州大学 大学院 病態機能内科学), 松本主之, 檜沢一興, 飯田三雄
Source：胃と腸(0536-2180)38巻4号 Page513-519(2003.04)
Abstract：全身性エリテマトーデス(SLE)における下部消化管病変は血管炎に基づくループス腸炎と蛋白漏出性腸症に大別される. ループス腸炎は, 小腸を主体とする急性発症の虚血性腸炎型と，大腸が主に罹患する多発潰瘍型に分類される. 虚血性腸炎型は小腸の浮腫を主体とし, 多発潰瘍型では消化管に打ち抜き様の多発潰瘍が発生する. 一方, 蛋白漏出性腸症は緩徐に発症し, 低蛋白血症と小腸の浮腫像を認める. ループス腸炎と蛋白漏出性腸症はsteroidに良好に反応するが, 多発潰瘍型では難治例が存在する. 以上のように, SLEにおける消化管病変は多彩であることを念頭に置き, 特に潰瘍性病変の治療には慎重な態度が必要と考えられる．
文献考察２）：lupus enteritisのCT所見（表）
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Radiology. 1999 Apr;211(1):203-9.
CT features of systemic lupus erythematosus in patients with acute abdominal pain: emphasis on ischemic bowel disease.
Byun JY, Ha HK, Yu SY, Min JK, Park SH, Kim HY, Chun KA, Choi KH, Ko BH, Shinn KS.
PURPOSE: To evaluate the computed tomographic (CT) features of systemic lupus erythematosus (SLE) in patients with acute abdominal pain. Special emphasis was placed on the analysis of ischemic bowel disease. MATERIALS AND METHODS: The authors retrospectively reviewed the images from 39 abdominal CT examinations performed in 33 patients with SLE and acute abdominal pain. Images were evaluated for bowel wall changes, mesenteric changes, fluid collection, retroperitoneal lymphadenopathy, peritoneal enhancement, and hepatomegaly as well as for changes in other abdominal organs. Ischemic bowel disease was diagnosed if at least three of the following signs were seen: bowel wall thickening, target sign, dilatation of intestinal segments, engorgement of mesenteric vessels, and increased attenuation of mesenteric fat. RESULTS: Thirty-one (79%) of the 39 examinations had CT findings diagnostic of ischemic bowel disease, including symmetric bowel wall thickening (n = 29), target sign (n = 26), and mesenteric vascular engorgement and haziness (n = 31). In 24 cases, bowel wall thickening was multifocal, with variable length, and did not appear to be confined to a single vascular territory. CONCLUSION: The most common CT finding in patients with SLE and acute abdominal pain is ischemic bowel disease. CT is useful for detecting the primary cause of gastrointestinal symptoms, planning treatment, and monitoring for infarction or perforation.PMID: 10189472 （full text）
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