Rectal ulcers - A rare gastrointestinal manifestation of systemic lupus erythematosus

A patient with systemic lupus erythematosus (SLE) developed a rectal ulcer and sepsis from colonic bacteria. At that time she had no other clinical ma nifestations of SLE. Histopathologic examination of the biopsies taken from the ulcer found evidence of vasculitis. Treatment with high-dose systemic steroids healed the ulcer clinically and endoscopically, but symptoms recur red when steroids were tapered. The patient was referred for surgery. This is a rare but dangerous complication of SLE and can be the only clinical ma nifestation of the disease.