Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2006; 12(44): 7206-7209
Published online Nov 28, 2006. doi: 10.3748/wjg.v12.i44.7206
Thrombotic microangiopathy involving the gallbladder as an unusual manifestation of systemic lupus erythematosus and antiphospholipid syndrome: Case report and review of the literature
Beatriz De-Leon-Bojorge, Samuel Zaltzman-Girsevich, Arturo Ortega-Salgado, Adelina Prieto-Patron, Ruth Córdoba-Córdoba, Marco Yamazaki-Nakashimada
Beatriz De-Leon-Bojorge, Department of Pathology, Instituto Nacional de Pediatría Mexico City, Mexico
Samuel Zaltzman-Girsevich, Department of Nephrology, Instituto Nacional de Pediatría Mexico City, Mexico
Arturo Ortega-Salgado, Department of Surgery, Instituto Nacional de Pediatría Mexico City, Mexico
Adelina Prieto-Patron, Ruth Córdoba-Córdoba, Yamazaki-Marco Nakashimada, Department of Clinical Immunology, Instituto Nacional de Pediatría Mexico City, Mexico
Correspondence to: Marco Yamazaki-Nakashimada, MD, Department of Clinical Immunology, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Col. Insurgentes Cuicuilco, C.P. 04350, Mexico City, Mexico. yzki71@yahoo.com.mx
Telephone: +52-55595526
Received: April 16, 2006
Revised: April 28, 2006
Accepted: May 25, 2006
Published online: November 28, 2006
Abstract

Gallbladder disease is no more common in patients with systemic lupus erythematosus (SLE) than in the general population. We describe a 17-year-old patient with SLE, who developed nephritis that was well controlled with medications. Initial treatment consisted of azathioprine, aspirin and prednisone with stable control of her symptoms. Two years later she developed a right quadrant abdominal pain, and an abdominal ultrasound revealed microlithiasic cholecystitis. Open cholecystectomy was performed and the histopathological findings revealed vasculitis with thrombotic microangiopathy in the gallbladder. This case presentation illustrates that calculous or acalculous cholecystitis should be considered as a manifestation of active SLE and APS.

Keywords: Gallbladder; Cholecystitis; Systemic lupus erythematosus; Antiphospholipid syndrome