TY - JOUR T1 - Cytomegalovirus-induced Colon Perforation in Systemic Lupus Erythematosus JF - The Journal of Rheumatology JO - J Rheumatol SP - 459 LP - 460 DO - 10.3899/jrheum.150964 VL - 43 IS - 2 AU - TETIANA GLUSHKO AU - VICTORIA A. MARCUS AU - INÉS COLMEGNA Y1 - 2016/02/01 UR - http://www.jrheum.org/content/43/2/459.abstract N2 - To the Editor:Acute abdomen has been reported in 10% of patients with systemic lupus erythematosus (SLE)1. The differential diagnoses of abdominal pain in SLE do not differ significantly from those in patients without SLE with the exception of serositis, thrombotic, or hemorrhagic events associated with antiphospholipid antibodies, mesenteric vasculitis (MV), and cytomegalovirus (CMV) infection. The distinction between MV and CMV infection is critical because both are life-threatening disorders requiring radically different therapeutic approaches. We describe the case of a patient with SLE who was profoundly immunosuppressed and who presented with an acute surgical abdomen secondary to a colonic perforation, and emphasize the relevance of considering a viral etiology in this setting.A 54-year-old woman with a 22-year history of SLE presented to the Emergency Department with acute abdominal pain. Previous manifestations of her disease included serositis, arthritis, nephritis, and cytopenias. In 2001, the patient received induction (cyclophosphamide) and maintenance [azathioprine (AZA)] therapy for class IV lupus nephritis (National Institutes of Health criteria activity index 5, chronicity index 8). Optimization of the AZA dose was limited because of myelosuppression. Over the previous 8 months, her creatinine … Address correspondence to Dr. I. Colmegna, Division of Rheumatology, Department of Medicine, McGill University Health Centre, Royal Victoria Hospital, 1001 Décarie Blvd., Bloc E, M2-3238, Montréal, Québec H4A 3J1, Canada. E-mail: ines.colmegna{at}mcgill.ca ER -