Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical symptoms that can imitate a number of other diseases. It affects predominantly young women aged 20-40 years but cases diagnosed at a younger age are not unusual.
We report a case of a young girl with failure to thrive and recurrent cystitis who presented abruptly with severe gastrointestinal manifestations requiring surgical treatment. Crohn's disease of the stomach was the most likely diagnosis, although no granuloma was found in tissue biopsies.
In spite of intensive immunosuppressive therapy, complete healing of the deep stomach ulcers was not achieved. Five years after the disease manifestation, the patient developed lupus nephritis with autoimmune haemolytic anaemia and finally a diagnosis of SLE was established.
Adequate therapeutic management of the disease consequently led to a significant improvement in the patient's clinical condition as well as laboratory results. This case report clearly points to the fact that in the case of atypical stomach ulcers, SLE must be considered in differential diagnosis.
In addition, diagnosis of SLE may be extremely challenging, especially in cases with exclusive gastrointestinal and urinary symptoms.