Acute acalculous cholecystitis induced by mesenteric inflammatory veno-occlusive disease (MIVOD) in systemic lupus erythematosus

Clin Rheumatol. 2003 Dec;22(6):447-9. doi: 10.1007/s10067-003-0766-6. Epub 2003 Oct 21.

Abstract

A 43-year-old woman with systemic lupus erythematosus (SLE) was treated for lupus pleurisy. During the course of her illness, she abruptly suffered severe right hypochondriac pain and high-grade fever. Abdominal ultrasonography revealed a thickening of the gallbladder wall without cholelithiasis, and she was diagnosed with acute acalculous cholecystitis (AAC). Laparoscopic cholecystostomy was performed. Pathological examination revealed lymphocytic venulitis without arteritis. Antiphospholipid antibodies were not demonstrated during the course of illness. From these findings, the cause of AAC was revealed as a mesenteric inflammatory veno-occlusive disease (MIVOD), which is a novel venopathy mainly affecting the mesenteric vein and/or its branches, causing serious ischemic complications. MIVOD should be considered as a possible cause of AAC.

Publication types

  • Case Reports

MeSH terms

  • Acalculous Cholecystitis / complications
  • Acalculous Cholecystitis / diagnosis*
  • Acalculous Cholecystitis / surgery
  • Adult
  • Biopsy, Needle
  • Cholangiography
  • Cholecystectomy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / therapy
  • Mesenteric Vascular Occlusion / complications
  • Mesenteric Vascular Occlusion / diagnosis*
  • Mesenteric Vascular Occlusion / therapy
  • Mesenteric Veins*
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome