FATAL AMEBIC-COLITIS IN A PATIENT WITH SLE - A CASE-REPORT AND REVIEWOF THE LITERATURE

Colitis in systemic lupus erythematosus (SLE) poses a diagnostic chall enge as clinical, radiological and laboratory findings are often non-s pecific. Fulminant amoebic colitis is a rare cause of death in SLE. Ea rly diagnosis coupled with timely surgery can reduce the mortality. Th e demonstration of haematophagous trophozoites in the stool is diagnos tic but insensitive. Early endoscopy with adequate specimen collection is an important part of the diagnosis. Serology is both sensitive and specific but can take up to 2-4 weeks for seroconversion making it le ss useful in a disease that takes a rapid downhill course if treated i nappropriately. We report a fatal case of colitis in a patient with SL E due to invasive amoebiasis which was complicated by Salmonella bacte raemia, disseminated intravascular coagulation, acute oliguric renal f ailure and adult respiratory syndrome. We also reviewed the literature on the clinical features and diagnosis of fulminant amoebic colitis. Amoebic colitis, although rare, should be considered in the differenti al diagnosis of lupus patients with colitis.