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Clinical features, severity and outcome of acute pancreatitis in systemic lupus erythematosus

  • Observational Research
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Abstract

Acute pancreatitis (AP) is a rare but life threatening manifestation of Systemic Lupus Erythematosus (SLE). The current study aims to study the clinical characteristics, severity, mortality, and outcome of SLE-related AP in Indian population. We retrospectively reviewed medical records of patients with SLE who had AP in the past. Data from 13 rheumatology centers across India were compiled. All patients satisfied SLICC criteria for SLE and ATLANTA criteria for AP. AP was classified in to mild, moderate and severe using revised Atlanta classification. Patients with known risk factors like gall stone and alcohol were excluded.Sixty-six patients (six, children) were studied. Majority of patients were females (82%). The median age of presentation was 24 (11–63) years and most patients (57.5%) presented within first year of diagnosis of lupus. AP occurred mostly in the setting of active lupus (89%). Active nephritis was seen in 39% while a fourth had CNS disease. Patients with severe AP had lower C3. Ascites and sepsis were most common local and systemic complications, respectively. Mortality was 17%. Hypocalcemia, presence of sepsis and shock predicted mortality. In the multivariate analysis, only presence of shock remained as independent predictor of death (OR 63.0, 95% CI: 5.2–760.3). Pancreatitis is an early manifestation of SLE and is associated with active disease. Significant mortality is seen particularly with severe pancreatitis.

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Authors and Affiliations

  1. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Hafis Muhammed, Avinash Jain, Ramnath Misra & Amita Aggarwal

  2. Nizam Institute of Medical Sciences, Hyderabad, India

    Mohammad Irfan & Liza Rajasekhar

  3. St John’s National Academy of Medical College, Bengaluru, India

    Sheba Charles & Vineeta Shobha

  4. Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Preksha Dwivedi, Varun Dhir & Aman Sharma

  5. Jaslok Hospital and Research Center, Mumbai, India

    Pallavi Pimpale Chavan & Raju Khubchandani

  6. Fortis Escorts Hospital, Jaipur, India

    Amit Sharma

  7. KEM Hospital, Pune, India

    Sanat Phatak

  8. Niruj Rheumatology Clinic, Ahmedabad, India

    Anuj N. Shukla

  9. One-Centre for Rheumatology and Genetics, Vadodara, India

    Ripal Shah

  10. Velammal Medical College Hospital, Madurai, India

    N. Subramanian

  11. Vedant Institute of Medical Sciences, Ahmedabad, India

    Sapan C. Pandya

  12. Manipal Hospital, Bengaluru, India

    Yogesh Preet Singh

  13. Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    K. G. Chengappa, Molly Thabah & V. S. Negi

  14. Currently SMS Medical College and Hospital, Jaipur, India

    Avinash Jain

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  1. Hafis Muhammed
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Correspondence to Amita Aggarwal.

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Muhammed, H., Jain, A., Irfan, M. et al. Clinical features, severity and outcome of acute pancreatitis in systemic lupus erythematosus. Rheumatol Int 42, 1363–1371 (2022). https://doi.org/10.1007/s00296-021-04834-2

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