071. ANCA ASSOCIATED MESENTERIC VASCULITIS IN SYSTEMIC LUPUS ERITHEMATOSUS (SLE) TREATED WITH INTRAVENOUS IMMUNOGLOBULIN (IVIG) Free

Background: Lupus mesenteric vasculitis (LMV) is one of the main causes of abdominal pain in lupus and is an uncommon and severe condition. Prevalence differs depending on areas, in Asia it is about 2.2- 9.7% and in America about 0.9%. It could be divided into acute ischemic enteritis and chronic multiple ulcers in the colon. LMV generally occurs in patients with active disease. Virus, bacteria and drugs have been proposed as a trigger factors. Possible mechanism of LMV are inflammatory vasculitis and thrombosis of the intestinal vessels.

Methods: Review of the clinical history and bibliography results. A 44 year-old woman with Lupus diagnosed at 18 years old, with mucocutaneous, articular and hematological manifestations. The patient had previous intolerance to azathioprine and hypertransaminasemia secondary to methotrexate. She had been diagnosed of breast cancer in 2010. She was admitted to our department because of diarrhea during two months. The patient suffered 9 episodes per day of diarrhea with blood and mucus, colic abdominal pain and fever. At the moment of admission she presented a cutaneous flare. A screening of infectious agents was negative included stool culture. Antiphospholipid antibodies were negative, AntiDNA were elevated and there was consumption of complement C 3. A colonoscopy was performed that showed a rectal ulcer. Angio- Tomography didńt showed lesions in the aorta or mesenteric arteries. Rectal biopsy didn’t present vasculitis or thombosis. ANCA-p antibodies were detected. Treatment with bolus of methilprednisolone and IGIV were initiated with resolution of symptoms.

Conclusion: There was no previous cases described of intestinal ANCA associated vasculitis in lupus patient. LMV is treated with intravenous infusions of methyprednisolone and immunosuppressive treatments, and refractory cases with intravenous cyclophosphamide. In our case IGIV was used because of the past history of cancer with satisfactory evolution.

Disclosures: None