Diving deep into lupus: Gastrointestinal involvement insights from the Oman lupus study

Objectives: This multicenter longitudinal study investigated the prevalence of gastrointestinal (GI) manifestations in lupus patients and determined the risk factors associated with mortality. Methods: This study is part of the Oman Lupus Study, which included 1160 patients who met the classification criteria for systemic lupus erythematosus (SLE) from January 2006 to February 2020. All patients were screened for GI symptoms and involvement. Results: We identified 91 patients with GI manifestations, with a prevalence rate of 8.53% in the pediatric group and 7.75% in the adult group, and this difference was not statistically significant (p =.755). Ischemic colitis was significantly associated with longer disease duration (p <.001) and positivity for B2-glycoprotein I (B2GPI) autoantibodies (p <.0001). Moreover, a significant correlation was found between ischemic colitis and hematologic manifestations (p =.001), lupus nephritis (p =.007), pulmonary complications (p =.000-.039), and some cardiac complications (p =.012-.269). Mortality rates were greater in patients with GI involvement (24.37%), including those with ischemic colitis (p =.005), chronic peritonitis (p <.001), and spleen/liver infarction (p =.001). Sepsis, thrombocytopenia, and different internal organ involvement rates were significantly associated with increased mortality. Conclusion: This research provides significant insights into GI manifestations in lupus patients. A higher mortality rate was found to be associated with organ involvement, disease duration, autoantibody profile, and specific complications. Considering this fact, it is vital to prioritize management strategies to improve clinical outcomes in this group of patients.