Systemic Lupus Erythematosus-associated Acute Acalculous Cholecystitis Successfully Treated by a Corticosteroid Combined with Azathioprine

• Published in: Internal Medicine Vol. 58; no. 19; pp. 2879 - 2885
• Main Authors: Kudo, Noritaka, Takaoka, Hirokazu, Shimomura, Taizo, Suzushima, Hitoshi, Fujiyama, Shigetoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-10-2019; Japan Science and Technology Agency
• Subjects: Acalculous Cholecystitis - diagnosis; Acalculous Cholecystitis - drug therapy; Acalculous Cholecystitis - etiology; acute acalculous cholecystitis; Acute Disease; Aged; Azathioprine; Azathioprine - therapeutic use; Calculi; Case Report; Cholecystitis; Computed tomography; Conservative Treatment; corticosteroid; Corticosteroids; Drug Therapy, Combination; Female; Fever; Gallbladder; Gallbladder diseases; Glucocorticoids - therapeutic use; Humans; Immunosuppressive Agents - therapeutic use; Internal medicine; Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - drug therapy; Methylprednisolone - therapeutic use; Pancytopenia; Pleural effusion; Surgery; Systemic lupus erythematosus; Tomography, X-Ray Computed; corticosteroid; azathioprine; systemic lupus erythematosus; acute acalculous cholecystitis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.2820-19

A 69-year-old Japanese woman was transferred to our hospital due to pancytopenia with a fever. She had Murphy's sign, and computed tomography showed pleural effusion and a swollen gallbladder without gallstones. We diagnosed her with systemic lupus erythematosus (SLE)-associated acute acalculous cholecystitis (AAC). Partly because her clinical and laboratory findings were not serious enough to warrant immediate surgical intervention, and partly because her poor general condition made her ineligible for surgery, surgical therapy was not selected. Corticosteroid therapy was performed with azathioprine, and the swelling in her gallbladder improved. As a conservative therapy for SLE-associated AAC, corticosteroid therapy combined with azathioprine might be beneficial.