{"id":2092,"date":"2018-10-20T18:40:28","date_gmt":"2018-10-20T16:40:28","guid":{"rendered":"https:\/\/angh.net\/abstracts\/une-jejunite-lupique\/"},"modified":"2018-11-29T11:16:20","modified_gmt":"2018-11-29T10:16:20","slug":"une-jejunite-lupique","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/une-jejunite-lupique\/","title":{"rendered":"Une j\u00e9junite lupique"},"content":{"rendered":"

2018<\/strong><\/p>\n

Gr\u00e9goire SALIN, Guillaume VELUT, Florence SKINAZI, H\u00e9l\u00e8ne LABADIE
\nCentre hospitalier DELAFONTAINE \u2028Service de gastroent\u00e9rologie 93200 Saint Denis<\/em><\/p>\n

Gastroent\u00e9rologie <\/strong>– \u00a02018-05-07 –\u00a0CC –<\/p>\n

________________________________<\/p>\n

Une patiente de 44 ans se pr\u00e9sente aux urgences pour des douleurs abdominales aigues depuis environ 36h. On note dans ses ant\u00e9c\u00e9dents un lupus \u00e9ryth\u00e9mateux syst\u00e9mique \u00e0 pr\u00e9dominance r\u00e9nale, articulaire et cutan\u00e9e trait\u00e9 par Cortancyl, Thalidomide, Plaquenil\u00a0; une hypertension art\u00e9rielle trait\u00e9e par Irb\u00e9sartan, une phl\u00e9bite des membres inf\u00e9rieurs, une infection par le virus ZIKA en septembre 2017 \u00e0 l\u2019occasion d\u2019un voyage \u00e0 la Martinique.
\nLes sympt\u00f4mes d\u00e9butent brutalement par une diarrh\u00e9e liquidienne puis apparition de selles noires devenant glaireuses 3h avant le passage aux urgences. Il n\u2019y a pas de fi\u00e8vre, pas de vomissement, pas de contage infectieux, pas de prise d\u2019AINS r\u00e9cente mais une prise de macrolide pour une bronchite un mois auparavant. L\u2019examen clinique retrouve une d\u00e9fense en hypochondre droit, des synovites des deux genoux et poignets, des glaires au toucher rectal. La biologie r\u00e9alis\u00e9e montre une h\u00e9moglobine \u00e0 10,8 g\/dl, des leucocytes \u00e0 7960 G\/mm3, des plaquettes \u00e0 198\u00a0000\/mm3. La cr\u00e9atinin\u00e9mie est \u00e0 85 \u00b5mol\/l, la CRP \u00e0 236 mg\/l, le compl\u00e9ment est effondr\u00e9 et le bilan h\u00e9patique normal. Les coprocultures et les h\u00e9mocultures sont n\u00e9gatives, les facteurs anti nucl\u00e9aires sont positifs avec des Anticorps anti SSA positifs. La tomodensitom\u00e9trie abdomino-pelvienne inject\u00e9e retrouve une j\u00e9junite sans signe de complication, un \u00e9panchement pleural bilat\u00e9ral et p\u00e9riton\u00e9al de faible abondance.
\nLa prise en charge initiale comporte une mise au repos digestif, des inhibiteurs de la pompe \u00e0 protons double dose, une HBPM \u00e0 dose pr\u00e9ventive, une antibioth\u00e9rapie par ofloxacine, flagyl et azythromycine ainsi qu\u2019une majoration de la corticoth\u00e9rapie \u00e0 60 mg\/j. L\u2019\u00e9volution est rapidement favorable tant sur le plan digestif qu\u2019articulaire.
\nLe diagnostic pos\u00e9 est une pouss\u00e9e lupique articulaire et s\u00e9rite dans un contexte de gastroent\u00e9rite infectieuse non document\u00e9e ou une pouss\u00e9e lupique digestive avec des manifestations articulaires et de s\u00e9rite.
\nNous discuterons des pathologies digestives au cours des maladies syst\u00e9miques connectivites et vascularites.<\/p>\n[download id=\u00a0\u00bb2227″]\n","protected":false},"excerpt":{"rendered":"

2018 Gr\u00e9goire SALIN, Guillaume VELUT, Florence SKINAZI, H\u00e9l\u00e8ne LABADIE Centre hospitalier DELAFONTAINE \u2028Service de gastroent\u00e9rologie 93200 Saint Denis Gastroent\u00e9rologie – \u00a02018-05-07 –\u00a0CC – ________________________________ Une patiente de 44 ans se pr\u00e9sente aux urgences pour des douleurs abdominales aigues depuis environ 36h. On note dans ses ant\u00e9c\u00e9dents un lupus \u00e9ryth\u00e9mateux syst\u00e9mique \u00e0 pr\u00e9dominance r\u00e9nale, articulaire et […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[29],"class_list":["post-2092","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-29"],"yoast_head":"\nUne j\u00e9junite lupique - Abstracts des congr\u00e8s de l'ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/une-jejunite-lupique\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Une j\u00e9junite lupique - 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