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g/d [54]. Finally, urine MCP-1 represents another biomarker of renal lupus in the absence of
cytokines, interferon- and growth factors [55].

Other Tests
The lupus patient may require specialized tests to look for more widespread organ
involvement. These may include echocardiograms, brain scans, and kidney scans; if evidence
exists of renal involvement, possibly a renal biopsy.

Lupus and Affects on Different Organs

In Table 2, we summarized the affects of multiple lupus variants on multiple organ


systems.

Lupus and the Gastrointestinal System

Lupus may demonstrate multiple manifestations within the gastrointestinal tract [55-58].
First, arteritis of the large intestine may cause diarrhea, lower abdominal pain and result in
ulceration of the intestine. Excessive fluid build-up in the peritoneal cavity (ascites) has been
described in lupus, and this may be caused by nephritis or other organ involvement. Chronic
diarrhea may be seen as a side effect of lupus medications. Pancreatitis and splenomegaly
may also be encountered [56-58]. Dysphagia may also occur, possibly due to arteritis in the
esophagus resulting in painful or difficult swallowing; this symptom is usually limited to
solid foods [55-58]. Gastroesophageal reflux (GER) disease may also occur with lupus. GER
represents a condition in which food and/or liquid travels backwards from the stomach into
the esophagus. It is common in lupus patients due to medications such as 1) corticosteroids,
and 2) nonsteroidal anti-inflammatory drugs (NSAIDs) affecting the intestine [56-58].
Gastroparesis can also occur; it represents a condition that reduces the stomach's ability to
empty contents in the absence of any blockage. Symptoms include bloating, abdominal
distention, nausea, vomiting and unintentional weight loss. Gastroparesis can be caused by
lupus itself, or by therapeutic medications. Enlargement of the liver (hepatomegaly) may also
be encountered in lupus patients [55-58]. Hepatomegaly may cause a feeling of fullness under
the right ribcage, and tenderness on examination. Inflammation of the liver (hepatitis) may
also be encountered in lupus, again caused by either the disease itself or by therapeutic
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medications. Symptoms of hepatitis include dark urine, loss of appetite, nausea, vomiting,
abdominal distension, pale or clay colored stools, fatigue, malaise and generalized itching.
Nausea and vomiting can also be caused by an arteritis in the stomach or small intestine [56-
58], or by a "pseudo-obstruction" (motility issue most likely caused by arteritis) of the
intestine. Finally, pancreatitis represents inflammation of the pancreas. Pancreatitis in lupus
may cause severe abdominal pain in the upper, middle or upper left part of the abdomen that
may radiate to the back; nausea, vomiting, fever, chills, a swollen or tender abdomen, and a

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