Systemic lupus erythematosus presenting as ischaemic proctitis

Ischaemic colitis is relatively uncommon in systemic lupus erythematosus (SLE), with only very few case reports or case series in world literature. Ischaemic colitis occurs when SLE activity is high and is inarguably due to small vessel vasculitis affecting the large or small intestine. Ischaemic proctitis with rectal ulceration, as a presenting feature in SLE, is even rarer with only two case reports in the world to date. We present the case of a 38-year-old woman, who presented with haematochezia which subsequently proved to be due to ischaemic proctitis with a large rectal ulcer in a case that was subsequently diagnosed as SLE. The clinical course in this patient greatly improved with aggressive management with systemic steroids.