Systemic lupus erythematosus unmasked: intestinal pseudo-obstruction as the first presentation

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory condition with a varied clinical presentation. It can involve multiple organ systems and has the potential to impact any part of the gastrointestinal tract. Intestinal pseudo-obstruction (IPO) is a rare yet severe gastrointestinal manifestation of SLE. Two-thirds of SLE patients with IPO present with concomitant hydroureteronephrosis. This report details the case of a young woman who presented with IPO as the initial manifestation of SLE. The presence of proteinuria with bilateral hydroureteronephrosis in this patient with IPO prompted a trail of investigations that led to the diagnosis of SLE. This diagnosis mitigated the need for surgery, as the patient responded to immunosuppressive therapy.