Chronic lupus peritonitis is characterized by the ascites with a large content of interleukin-6

Ryu Watanabe, Hiroshi Fujii, Yukiko Kamogawa, Kyohei Nakamura, Tsuyoshi Shirai, Tomonori Ishii, Hideo Harigae

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease and can cause multi-organ damage. Peritoneal involvement, also called lupus peritonitis, is a rare but sometimes fatal manifestation. Deposition of immune complexes consisting of immunoglobulin G and complement is considered to be involved in the pathogenesis of lupus peritonitis; however, it remains unknown whether infammatory cytokines contribute to the pathology of this manifestation. Here we present two patients with treatment-resistant lupus peritonitis: a 37-year-old woman with a 26-year history of SLE who had been treated with prednisolone and cyclophosphamide followed by azathioprine and a 65-year-old woman with a 33-year history of SLE who had been treated with prednisolone alone. Both patients were admitted to our department because of abdominal distention. Computed tomography scans showed massive ascites. Ascitic fuid examinations of both patients showed leukocytosis with no evidence of malignancy or infection. After eliminating other causes for ascites, they were diagnosed with lupus peritonitis. Despite the intensified immunosuppressive therapy, they died of uncontrolled peritonitis several months after admission. Examinations of the ascites at admission also revealed a large content of interleukin (IL)-6, compared with other inflammatory cytokines, IL-1β and tumor necrosis factor-α. In fact, the ascitic IL-6 levels of these two patients were 12,389 pg/mL and 5,486 pg/mL, much higher than their serum IL-6 levels of 36 pg/mL and 140 pg/mL, respectively. We therefore suggest that IL-6 may contribute to the pathogenesis of lupus peritonitis and that the inhibition of IL-6 signaling may provide a novel therapeutic strategy for lupus peritonitis.

Original languageEnglish
Pages (from-to)289-294
Number of pages6
JournalTohoku Journal of Experimental Medicine
Volume235
Issue number4
DOIs
Publication statusPublished - 2015 Mar 28

Keywords

  • Ascites
  • Cytokine
  • Interleukin 6
  • Lupus peritonitis
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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