Severe, Recurrent Mesenteric Vasculitis as the Initial Presentation of Systemic Lupus Erythematosus

Gastrointestinal symptoms are common in systemic lupus erythematous (SLE) patients and more than half of them are caused by adverse reactions to medications and infections. Cases of mesenteric vasculitis in SLE are well described; however, we describe a condition of severe, recurrent lupus vasculitis accompanied with hypocomplementemia as the initial presentation of SLE. Lupus should be suspected in any patient with computed tomography findings of ischemic enteritis, even without lupus-related symptoms or signs. C3/C4 levels may be helpful.