Pathogenetic Association of Digestive System Lesions with Systemic Lupus Erythematosus:
Characteristics and Prevalence
Authors: Abrahamovych Ulyana , Abrahamovych Orest , Nadashkevich Oleh , Farmaha Marta , Kobak Liubov 
Published: May 2020

Introduction

The prevalence rate of the digestive system lesions in patients with systemic lupus
erythematosus (SLE) ranges from 8.0 to 50.0%. The symptoms caused by systemic lupus
erythematosus (immunocomplex inflammation, vasculitis, etc.) have not been clearly
distinguished yet from those that are associated with co-occurring diseases or adverse
effects of medications used to treat patients with SLE.

Objective

To characterize and clarify the prevalence of the digestive system lesions that are
pathogenetically associated with systemic lupus erythematosus.

Materials and methods

370 patients (331 women and 39 men), stratified by age, duration, and activity of SLE,
were included in the study and subjected to comprehensive examinations. The results were
processed in Microsoft Excel using descriptive statistics, χ2 test, z-test for comparisons
between two proportions; the relationship was considered to be statistically significant
when p < 0.05.

Results

The digestive system lesions were detected in 225 (60.81%) patients with systemic lupus
erythematosus. The prevalence of steatohepatitis, autoimmune hepatitis, and chronic
pancreatitis rose with the progression of the underlying disease, so we concluded that they
may be considered to be pathogenetically associated with systemic lupus erythematosus as
syntropic comorbid lesions. Other digestive system lesions – chronic pharyngitis,
cardiochalasia, gastroesophageal reflux disease, esophagitis, chronic gastritis, peptic
ulcer, chronic duodenitis, duodenogastric reflux, duodenal ulcer, chronic viral hepatitis B,
chronic viral hepatitis C, toxic hepatitis, liver cirrhosis, acalculous cholecystitis,
chronic cholecystitis (asymptomatic gallstones, chronic calculous cholecystitis, gallbladder
polyps), irritable bowel syndrome, chronic colitis, hemorrhoids, dolichosigma, peritoneal
adhesions – are only comorbidities, ie. co-occurring digestive system lesions, since there
was no relationship between their prevalence and the progression of the underlying disease.
The mesenchymal inflammatory syndrome was detected in most patients with systemic lupus
erythematosus and pathogenetically associated syntropic comorbid steatohepatitis.
Hepatocellular dysfunction syndrome was detected in the three-fourths of patients with SLE
and steatohepatitis. The mesenchymal inflammatory syndrome was also detected in all patients
with SLE and pathogenetically associated syntropic comorbid autoimmune hepatitis. More than
half of the patients with SLE and autoimmune hepatitis were also diagnosed with
hepatocellular dysfunction and hepatic cytolysis syndromes. The asthenic-neurotic clinical
syndrome occurred in the three-fourths of patients with SLE and pathogenetically associated
syntropic comorbid chronic pancreatitis. Almost every second patient with SLE and chronic
pancreatitis had a dyspeptic syndrome. Steatohepatitis was detected predominantly in
patients aged 25 to 59 (young age subgroup II and middle age group). It was not detected in
patients with the SLE duration of less than one year. Autoimmune hepatitis was detected
predominantly in elderly patients and patients with the SLE duration of more than ten years.
Chronic pancreatitis was significantly less prevalent in women and more prevalent in elderly
patients – it occurred in almost half of them. It was absent in patients with the SLE
duration of less than one year. Patients with the SLE duration of 6-10 years had the highest
prevalence of chronic pancreatitis.