SLE Manifesting as AIHA and Gut Lupus in a Male Patient

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that predominantly affects women but rarely manifests in males. This report presents a rare case of SLE in a 20-year-old male with autoimmune hemolytic anemia (AIHA) and intestinal pseudo-obstruction, complicated by septic shock. The patient exhibited hematologic and gastrointestinal (GI) manifestations, including anemia, malar rash, and abdominal distention. Early evaluation revealed severe anemia with hemolysis confirmed by positive Coombs tests and reduced complement levels. Imaging identified intestinal pseudo-obstruction. The primary objective was to manage hematologic and GI symptoms effectively. Methylprednisolone and cyclosporine were administered alongside antibiotics to address septic shock. Initial management included leukoreduced blood transfusion and fluid therapy. The patient demonstrated significant clinical and laboratory improvements within days, including normalized bowel function and stabilized hemoglobin levels. This case emphasizes the importance of early diagnosis and multidisciplinary management in rare male presentations of SLE. The findings also highlight the challenges of diagnosing SLE-related intestinal pseudo-obstruction due to its rarity and overlapping symptoms with other conditions. Prompt treatment with corticosteroids and immunosuppressants resulted in favorable outcomes, avoiding complications such as unnecessary surgical interventions. This study underscores the significance of considering SLE in differential diagnoses for young males presenting with hematologic and GI symptoms. Further research is necessary to explore the pathophysiology and optimal treatment approaches for rare SLE manifestations. Early intervention is critical to reducing morbidity and improving quality of life for patients with atypical presentations.