{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:08:27Z","timestamp":1789459707745,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Systemic lupus erythematosus (SLE) is a complex autoimmune condition with diverse manifestations. Childhood-onset SLE (cSLE) presents more severely than adult-onset disease with a higher incidence of severe neurologic or renal manifestations and lower estimated survival rates. There is limited literature on the range of severe gastrointestinal manifestations at presentation in cSLE, and this lack of information results in underappreciation of these potentially life-threatening complications and little guidance regarding management of these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed cases of patients with cSLE and severe GI manifestations at presentation diagnosed at our institution and additionally provide a comprehensive review of existing cases in the literature to discuss presenting symptoms, other clinical features, longitudinal course, treatment, and long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified six cases of cSLE with primary, severe GI symptoms at time of diagnosis at our institution and an additional 25 patients who presented similarly in the literature. Severe GI manifestations included protein-losing enteropathy, thoracoabdominal aortitis, severe pancreatitis, lupus enteritis or mesenteric vasculitis, and intestinal pseudo-obstruction. Delays in diagnosis affected several patients, and 26% of patients required surgical intervention. Many patients required intensive immunomodulatory treatment in addition to prolonged bowel rest and parenteral nutrition. Long-term outcomes of GI manifestations varied overall, however, most patients at our institution achieved clinical remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Understanding these rare cases of severe GI manifestations in cSLE can aid clinicians in prompt diagnosis and collaborative management, improving clinical outcomes for this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033251345020","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T19:23:25Z","timestamp":1747855405000},"page":"721-741","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe gastrointestinal manifestations in childhood-onset lupus: A single-center cohort and review of the literature"],"prefix":"10.1177","volume":"34","author":[{"given":"James","family":"Orozco","sequence":"first","affiliation":[{"name":"Boston Children\u2019s Hospital"},{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3121-8489","authenticated-orcid":false,"given":"Jessica","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"},{"name":"Texas Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara MM","family":"Yasrebi","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnie","family":"Blalock","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L","family":"Grisales","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig L","family":"Jensen","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"},{"name":"Texas Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta M","family":"DeGuzman","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine"},{"name":"Texas Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70174-5"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.121"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex260"},{"key":"e_1_3_5_5_2","first-page":"113","article-title":"The morbidity and mortality associated with childhood onset systemic lupus erythematosus","volume":"17","author":"Huang JL","year":"1994","unstructured":"Huang JL, Lin CJ, Hung IJ, et al. 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Gastrointestinal and hepatic involvement in paediatric systemic lupus erythematosus. Clin Exp Rheumatol. https:\/\/www.clinexprheumatol.org\/abstract.asp?a=16538 (accessed 11 April 2025).","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2015.09.022"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/014107689709000117"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/096120330000900104"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31816b6b7b"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/PG9.0000000000000041"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001480"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80266-6"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(82)80102-0"},{"key":"e_1_3_5_22_2","first-page":"1269","article-title":"Protein losing enteropathy as the initial manifestation of childhood systemic lupus erythematosus","volume":"23","author":"Molina JF","year":"1996","unstructured":"Molina JF, Brown RF, Gedalia A, et al. Protein losing enteropathy as the initial manifestation of childhood systemic lupus erythematosus. J Rheumatol 1996; 23: 1269\u20131271.","journal-title":"J Rheumatol"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2004.45.5.923"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes157"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2015.01.009"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31819f1df4"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-2892-3"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3841-0"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000001317"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/09612033211045923"},{"key":"e_1_3_5_31_2","first-page":"570","article-title":"Acute abdomen: the presenting sign of systemic lupus erythematosus in childhood","volume":"35","author":"Lepore L","year":"2022","unstructured":"Lepore L, Facchini S, Codrich D, et al. 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PLoS One 2015; 10: e0132758.","journal-title":"PLoS One"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12144"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-199206000-00003"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.98.4.680"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033251345020","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033251345020","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033251345020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:29:00Z","timestamp":1777678140000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033251345020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":37,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/09612033251345020"],"URL":"https:\/\/doi.org\/10.1177\/09612033251345020","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,21]]}}}