GASTROINTESTINAL AND HEPATIC MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS – A NARRATIVE REVIEW

Introduction and purpose: Systemic lupus erythematosus is a chronic, multifaceted autoimmune disorder. Throughout its course, it affects multiple organ systems, such as the skin, joints, kidneys, cardiovascular system, and central nervous system, among others. Less frequently observed clinical presentations include gastrointestinal involvement and hepatic symptoms. The objective of this review is to present and familiarise readers with these atypical manifestations, which are mostly not included in the diagnostic criteria for lupus, and which can pose a significant diagnostic challenge. Description of the state of knowledge: Gastrointestinal (GI) and hepatic symptoms among patients with lupus may be related to the disease itself, but can also result from the side effects of treatment, viral infections, or emerge as a consequence of the overlap of two diseases. The gastrointestinal tract may exhibit symptoms of the disease at practically any point along its course, from the oral cavity to the anus. The most common GI manifestations include conditions such as oral ulcers, dysphagia, lupus enteritis, protein-losing enteropathy, intestinal pseudo-obstruction, and pancreatitis. Rare, but clinically significant presentations of lupus involving the liver, which are important due to their chronic health consequences, include autoimmune hepatitis and lupus hepatitis. Conclusions: Patients with systemic lupus erythematosus who present with gastrointestinal or hepatic symptoms require prompt diagnosis, as these conditions, if not properly managed, contribute to increased mortality. It is also possible for these manifestations to appear as the initial signs of SLE. Therefore, familiarity with their characteristics is crucial to avoid delays in diagnosis and in the implementation of appropriate treatment.