SLE dengan Mesenteric Vasculitis

Panggilannya : LMV (Lupus Mesenteric Vasculitis)

Gejala bisa saja :

1. Abdominal angina, pain in the colon, distension and pseudo-blockage
2. Nausea, anorexia, vomiting and abdominal distension
3. Mesenteric vasculitis is an extremely serious complication and is highly lethal (50%)

Abdominal CT (with contrast):

• Showed discrete ascites and diffuse jejunoileal thickening, with the “target sign,” suggestive of an ischemic process that takes place in the microvasculature
• Comb Sign (seperti sisir)
  

From a histopathological point of view :

• mesenteric vasculitis is an inflammatory process of the vascular wall, with fibrinoid necrosis that drives regional ischemia and dysfunction of the intrinsic intestinal musculature. 
• This condition is characterized by the deposition of complement, fibrinogen and immune complexe

Mesenteric vasculitis is associated with pyelo-ureteral smooth musculature alterations in 67% of cases involving pyelo-ureteral hydronephrosis.

Treatment 

• Methylprednisolone loadng 1000 mg/hari selama 3 hari diikuti dengan maintenance (1 mg/kg/ day) tapp off
• Antibiotik empirik
• Bila indikasi, emergency laparotomy