{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:06:40Z","timestamp":1785276400911,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,21]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>Systemic lupus erythematosus (SLE) is an autoimmune inflammatory condition with a varied clinical presentation. It can involve multiple organ systems and has the potential to impact any part of the gastrointestinal tract. Intestinal pseudo-obstruction (IPO) is a rare yet severe gastrointestinal manifestation of SLE. Two-thirds of SLE patients with IPO present with concomitant hydroureteronephrosis. This report details the case of a young woman who presented with IPO as the initial manifestation of SLE. The presence of proteinuria with bilateral hydroureteronephrosis in this patient with IPO prompted a trail of investigations that led to the diagnosis of SLE. This diagnosis mitigated the need for surgery, as the patient responded to immunosuppressive therapy.<\/jats:p>","DOI":"10.1136\/bcr-2024-263491","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T11:55:14Z","timestamp":1739188514000},"page":"e263491","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Systemic lupus erythematosus unmasked: intestinal pseudo-obstruction as the first presentation"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1393-7292","authenticated-orcid":false,"given":"Dandi","family":"Kranthi","sequence":"first","affiliation":[{"name":"Medical Gastroenterology, Dr DY Patil Medical College, Hospital & Research Center, Dr DY Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharshtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7794-7831","authenticated-orcid":false,"given":"Debabrata","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Medical Gastroenterology, Dr DY Patil Medical College, Hospital & Research Center, Dr. DY Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8545-4751","authenticated-orcid":false,"given":"Amol","family":"Dahale","sequence":"additional","affiliation":[{"name":"Medical Gastroenterology, Dr DY Patil Medical College, Hospital & Research Center, Dr. DY Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5564-8002","authenticated-orcid":false,"given":"Abhijeet Bhausaheb","family":"Karad","sequence":"additional","affiliation":[{"name":"Medical Gastroenterology, Dr DY Patil Medical College, Hospital & Research Center, Dr. DY Patil Vidyapeeth (Deemed to be University), Pimpri, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"key":"2025082804065930000_18.2.e263491.1","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1007\/s00296-022-05183-4","article-title":"Global and regional prevalence and incidence of systemic lupus erythematosus in low-and-middle income countries: a systematic review and meta-analysis","volume":"42","author":"Fatoye","year":"2022","journal-title":"Rheumatol Int"},{"key":"2025082804065930000_18.2.e263491.2","first-page":"1404","article-title":"Major gastrointestinal manifestations in lupus patients in Asia: lupus enteritis, intestinal pseudo-obstruction, and protein-losing gastroenteropathy","volume":"19","author":"Chng","year":"2010","journal-title":"Lupus (Los Angel)"},{"key":"2025082804065930000_18.2.e263491.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.10.917"},{"key":"2025082804065930000_18.2.e263491.4","doi-asserted-by":"publisher","DOI":"10.1136\/gut.41.5.675"},{"key":"2025082804065930000_18.2.e263491.5","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150074"},{"key":"2025082804065930000_18.2.e263491.6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.medcli.2023.08.014","article-title":"Intestinal pseudo-obstruction due to IgG4-related disease","volume":"162","author":"Esplugues Clos","year":"2024","journal-title":"Med Clin (Barc)"},{"key":"2025082804065930000_18.2.e263491.7","first-page":"377","article-title":"Systemic lupus erythematosus and chronic intestinal pseudoobstruction","volume":"20","author":"Cacoub","year":"1993","journal-title":"J Rheumatol"},{"key":"2025082804065930000_18.2.e263491.8","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000248","article-title":"Intestinal pseudo-obstruction in systemic lupus erythematosus: a case report and review of the literature","volume":"93","author":"Wang","year":"2014","journal-title":"Medicine (Baltimore)"},{"key":"2025082804065930000_18.2.e263491.9","first-page":"328","article-title":"Chronic intestinal pseudo-obstruction associated with biliary tract dilatation in a patient with systemic lupus erythematosus","volume":"14","author":"Pardos-Gea","year":"2005","journal-title":"Lupus (Los Angel)"},{"key":"2025082804065930000_18.2.e263491.10","first-page":"458","article-title":"Chronic intestinal pseudo-obstruction in systemic lupus erythematosus due to intestinal smooth muscle myopathy","volume":"9","author":"Hill","year":"2000","journal-title":"Lupus (Los Angel)"},{"key":"2025082804065930000_18.2.e263491.11","doi-asserted-by":"crossref","unstructured":"Fanouriakis A , Tziolos N , Bertsias G , et al . 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