SEVERE ACUTE PANCREATITIS REVEALING SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect multiple organs. Pancreatic involvement, although rare, has an estimated frequency ranging from 0.7% to 4.2%. It typically occurs in advanced stages of the disease but can exceptionally be an inaugural manifestation, as in the case reported here.The patient was a 24-year-old woman with no prior medical history, admitted for acute respiratory distress associated with abdominal pain. The diagnosis of acute pancreatitis was confirmed by a marked increase in serum lipase levels and an abdominal CT scan showing a swollen pancreas with peripancreatic collections (stage E according to Balthazar).After ruling out common causes of pancreatitis, immunological testing revealed positive antinuclear and anti-DNA antibodies, as well as decreased C3 and C4 complement fractions. The presence of pleural and pericardial effusions, combined with biological signs of active lupus, led to the diagnosis of SLE based on the 2019 ACR/EULAR criteria.