We report the case of a 29 year old woman with a protein losing enteropathy caused by systemic lupus erythematosus presenting with periorbital oedema. Only three other cases of protein losing enteropathy due to systemic lupus erythematosus have been described, two of which were thought to be because of a primary enteropathy, although the exact pathogenesis was unknown. We suggest that both the protein losing enteropathy and periorbital oedema in this patient were because of increased capillary permeability to serum albumin, as a result of products of plasma C3 conversion which were present in large amounts. It is also of interest that the antigen/antibody system in this patient was RNP/anti-RNP and that DNA antibodies were not detected. This patient falls into a subset of systemic lupus erythematosus in which anti-DNA antibodies are not present, some of which appear to have a more favourable prognosis.
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