Acute pancreatitis is an uncommon manifestation of systemic lupus erythematosus (SLE) and the frequency of this association is unknown. Nevertheless, acute pancreatitis is an important differential diagnosis in the evaluation of abdominal pain in individuals with SLE. Patients usually present with pain of variable intensity, sometimes simulating acute abdomen. Several factors have been implicated in the pathogenesis of this condition, such as autoimmune events, vasculitis, antiphospholipid antibodies and drugs. The role of corticosteroids as an etiological factor is still controversial. Moreover, in some reports the maintenance of corticosteroids was crucial in the patients' recovery. We report two patients with SLE, who presented with acute pancreatitis. In neither of the cases evidence of any known predisposing factors was present and, therefore, the condition was considered a manifestation of lupus activity. One of the patients died as a consequence of systemic inflammatory response secondary to pancreatitis. In the other case, stress doses of corticoids were used in the treatment, resulting in a good outcome.
systemic lupus erythematosus; acute pancreatitis; corticosteroids