Successful treatment of massive ascites with intraperitoneal administration of a steroid in a case of systemic lupus erythematosus

Massive ascites is a rare manifestation of systemic lupus erythematosus (SLE) and has a poor response to glucocorticoid therapy, probably because of impaired vascular circulation due to persistent peritoneal inflammation. We describe a young woman presenting with massive painless ascites as the predominant manifestation of SLE. Peritoneal effusion was resistant to the oral administration of steroids and the conventional therapies for ascites. Intraperitoneal injection of triamcinolone, an insoluble glucocorticoid, induced dramatic remission of massive ascites, with no adverse event or recurrence. Lupus (2009) 18, 740-742.