Mesenteric Vasculitis Presented as Recurrent Epigastric Pain in Childhood Onset Systemic Lupus Erythematosus

Vasculitis is one of the serious manifestation for systemic lupus erythematosus (SLE). Mesenteric vasculitis was rarely identified, hence potentially misdiagnoses. The objective of this case report was to describe undiagnosed mesenteric vasculitis in childhood onset SLE under treatment. A 17-year-old girl was admitted due to recurrent epigastric pain accompanied by nausea, vomiting, and diarrhea. The patient was diagnosed with mild severity SLE since May 2022 and treated with methotrexate. Abdominal physical examination was within normal limits. A contrast abdominal computed tomography-scan showed symmetrical circular thickening of the small intestine wall and colon, suggestive of lupus mesenteric vasculitis (LMV). High-dose methylprednisolone was introduced for 3 days, followed by mycophenolate sodium. Patient’s condition was improved after the treatment. In patient with childhood onset SLE who suffered from recurrent abdominal pain, LMV should be considered.