THU0386 Difference of image features on computed tomography between lupus enteritis and mesenteric vasculitis of other connective tissue diseases
Authors: Y. Yoshida, T. Kondo, K. Yukawa, T. Tokunaga, T. Kuranobu, K. Oi, T. Nojima, S. Hirata, E. Sugiyama
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Lupus enteritis(LE), lupus mesenteric vasculitis, occurs occasionally in systemic lupus erythematosus(SLE). Not only LE but also other mesenteric vasculitis can lead to bowel haemorrhage or perforation and will be fatal, but it is difficult to demonstrate histologically-proven vasculitis on endoscopic biopsy.<sup><sup>1</sup></sup> Although several computed tomography (CT) features of LE are reported, we have little knowledge about whether they differ from those of other mesenteric vasculitis. <h3>Objectives</h3> To clarify the imaging pattern on CT which can distinguish LE from other mesenteric vasculitis. <h3>Methods</h3> Patients diagnosed with LE and non-LE at our hospital were consecutively registered from January 2009 to August 2017. The diagnosis of LE was made by the criteria of <sup><sup>BILAG 2004</sup></sup> which is defined as either vasculitis or inflammation of small or large bowel with supportive imaging and/or biopsy findings.<sup><sup>2</sup></sup> Non-LE was defined as mesenteric vasculitis of other connective tissue diseases(CTDs). We compared the contrast-enhanced CT patterns of LE with non-LE. Statistical analyses were performed using XLSTAT. <h3>Results</h3> A total of 8 patients were diagnosed with LE and enrolled in this study. The mean age was 41.1 years old, range 23–53, and 7 were females. CT exams of all 8 patients demonstrated small bowel wall thickening, dilatation of intestine and comb sign (indicating engorgement of mesenteric vessels). Severe bowel wall thickening (&gt;8 mm) was observed in 87.5% (n=7), ascites in 75.0% (n=6) and target sign (indicating abnormal bowel wall enhancement) in 62.5% (n=5). 5 patients were enrolled in non-LE (1 eosinophilic granulomatosis with polyangiitis, 1 IgA vasculitis and 3 Behcet's disease). Comparison of CT findings between LE patients and non-LE patients were summarised on table 1. Bowel wall thickness and comb sign were common in both groups, however the prevalence of dilatation of intestine in LE patients was significantly higher than in non-LE patients. Although not significant, complication of large bowel involvement was shown only in LE patients. <h3>Conclusions</h3> Dilatation of intestine on CT is significant to distinguish LE from mesenteric vasculitis of other CTDs. <h3>References</h3> [1] Janssens P, et al: Orphanet J Rare Dis2013;8:67. [2] Isenberg DA, et al: Rheumatology(Oxford). 2005;44:902–6. <h3>Disclosure of Interest</h3> Y. Yoshida Speakers bureau: Bristol-Myers Squibb, Chugai, Sanofi, T. Kondo: None declared, K. Yukawa: None declared, T. Tokunaga: None declared, T. Kuranobu: None declared, K. Oi: None declared, T. Nojima: None declared, S. Hirata Grant/research support from: Eli Lilly, UCB, Consultant for: Bristol-Myers Squibb, UCB, Paid instructor for: AbbVie, Eisai, Tanabe-Mitsubishi, Speakers bureau: AbbVie, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Jansen, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, UCB, E. Sugiyama Grant/research support from: AbbVie, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, Speakers bureau: AbbVie, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eli Lilly, Kissei, Pfizer, Sanofi, Tanabe-Mitsubishi, Actelion