{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T14:10:43Z","timestamp":1772633443539,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lupus mesenteric vasculitis (LMV) is a rare but life-threatening gastrointestinal complication of systemic lupus erythematosus (SLE). Refractory cases pose significant therapeutic challenges due to limited treatment options and cumulative toxicity from long-term immunosuppressant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 46-year-old woman with SLE presented with recurrent abdominal pain, diarrhea, and malar rash over a 1-year period. Despite receiving standard immunosuppressive therapies\u2014including glucocorticoids (GCs), cyclophosphamide, mycophenolate mofetil, and tacrolimus\u2014she experienced multiple relapses of LMV between 2015 and 2020, confirmed by abdominal computed tomography showing bowel wall thickening and the characteristic \u201ctarget sign.\u201d In September 2020, belimumab (600 mg intravenous every 4 weeks) was initiated alongside a reduced-dose GC regimen. Over a 49-month treatment period (34 doses), the patient achieved sustained remission, with complete resolution of abdominal symptoms, normalization of computed tomography findings, stable Systemic Lupus Erythematosus Disease Activity Index scores (0\u20134), decreasing anti-double-stranded DNA titers (&amp;lt;20 IU\/mL), and rising serum complement C3 levels (&amp;gt;0.6 g\/L). GC dosage was successfully tapered to 2.5 mg\/day without disease relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case demonstrates belimumab\u2019s efficacy in achieving the longest documented remission (49 months) in refractory LMV, highlighting its potential as a first-line biologic for steroid-dependent gastrointestinal vasculitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1687299","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:26:51Z","timestamp":1772609211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Belimumab-induced remission in refractory lupus mesenteric vasculitis: a case report with 49-month follow-up"],"prefix":"10.3389","volume":"17","author":[{"given":"Wen-jia","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiangsu Province (Suqian) Hospital","place":["Suqian, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi-feng","family":"Zang","sequence":"additional","affiliation":[{"name":"School of Life Sciences, Bengbu Medical University","place":["Bengbu, Anhui, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiangsu Province (Suqian) Hospital","place":["Suqian, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin-shan","family":"Zang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiangsu Province (Suqian) Hospital","place":["Suqian, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i24.2971","article-title":"Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment","volume":"16","author":"Tian","year":"2010","journal-title":"World J Gastroenterol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4103\/sjmms.sjmms_511_18","article-title":"Mesenteric vasculitis as a rare initial presentation of systemic lupus erythematosus: a case report","volume":"8","author":"Alshehri","year":"2020","journal-title":"Saudi J Med Med Sci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100900","article-title":"A nomogram to predict the risk of lupus enteritis in systemic lupus erythematosus patients with gastrointestinal 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