Gastrointestinal manifestations in systemic lupus erythematosus: data from an Indian multi-institutional inception (INSPIRE) cohort.

This article focuses on the prevalence, clinical associations, and outcomes of gastrointestinal (GI) manifestations in systemic lupus erythematosus (SLE) within the Indian SLE Inception cohort for REsearch (INSPIRE). Among 2,503 patients with newly diagnosed SLE, 9.7% exhibited GI manifestations early in the disease course, with ascites being the most common, followed by lupus enteritis, pancreatitis, and hepatitis. GI involvement was associated with younger age, pleural effusion, thrombocytopenia, myositis, hypoalbuminemia, elevated alkaline phosphatase and bilirubin, and lower frequencies of alopecia, elevated anti-double-stranded DNA, and anti-U1RNP antibodies compared to patients without GI features. Mortality in the GI group was 11.9%, significantly higher than in those without GI manifestations, and was linked to higher systemic disease activity and lower socioeconomic status. The study highlights the importance of early recognition of GI involvement in SLE due to its association with increased disease severity and mortality.