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Abstract
In two patients with systemic lupus erythematosus, an acute lupus crisis developed
with multisystem involvement that included peritonitis. Paracentesis was performed
and the fluid obtained was sterile and serous. In one patient the antinuclear antibody
test performed on the paracentesis fluid showed 4+ peripheral staining. The clinical
impression that these episodes represented lupus activity was supported by the results
of paracenteses. Laparotomy was not performed and the patients were treated with high
doses of intravenous steroids and antibiotics with a favorable response. Frequent
abdominal examinations and follow-up gastrointestinal series did not disclose ulceration
and/or perforation which may have been masked by the steroids. Paracentesis is recommended
as a useful method of distinguishing perforation from peritonitis in patients with
systemic lupus erythematosus presenting with an acute abdomen.
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© 1972 Published by Elsevier Inc.
