Necrotizing pancreatitis in a patient diagnosed with SLE; rare case reportMaryam Javid1 ,Tohid Damideh2, Omid pourbagherian1 , Mehdi Jafarpour31 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran2Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran3Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IranDrafting of the manuscript: Maryam Javid, Mehdi JafarpourData Collection: Omid pourbagherian, Tohid DamidehCritical revision of the manuscript for important intellectual content: Mehdi Jafarpour, Maryam JavidCase supervision: Mehdi JafarpourCorresponding author: Mehdi JafarpourAddress: Connective Tissue Diseases Research Center, Flat 1, Imam Reza Hospital, Tabriz, IranPhone number: 0098 41 33332704Fax: 0098 41 35413520Mobile: 09148651269Corresponding author e-mail address: [email protected]: Necrotizing pancreatitis, Systemic Lupus Erythematosus, inflammation Written informed permission from the patient to publish the facts and photographs was granted.

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IntroductionInflammatory bowel disease (IBD) refers to a collection of chronic, idiopathic inflammatory/autoimmune disorders of the gastrointestinal tract characterized by relapsing and remitting episodes(1). The two main types of IBD are Crohn’s disease and ulcerative colitis which lead to a various type of debilitating symptoms such as abdominal pain, rectal bleeding, weight loss, and diarrhea. The precise mechanisms underlying IBD pathogenesis remain unclear but are thought to involve a dysfunctional interplay between host genetics, the intestinal immune system, and environmental factors(2). Current evidence suggests IBD results from an aberrant immune response directed against commensal gut bacteria in genetically susceptible individuals(3). Multiple genetic loci have been implicated in IBD risk, including genes involved in epithelial barrier function, microbial sensing, and immunoregulation. However, genetics alone cannot explain IBD’s rising incidence, highlighting the likely contribution of environmental risk factors like diet, smoking, medications, stress, and the microbiome. Ongoing research aims to better delineate the complex immunopathogenesis of IBD in order to identify improved diagnostic markers, prognostic indicators, and therapeutic targets(4). Moreover, Individuals diagnosed with IBD frequently encounter an array of difficulties that extend beyond the gastrointestinal system. One such challenge is the emergence of mononeuritis multiplex. This association between ulcerative colitis and mononeuritis multiplex underscores the intricate and multifaceted nature of these autoimmune disorders. The occurrence of symptoms of one condition in individuals afflicted by the other warrants careful examination by medical specialists. This necessitates a thorough investigation into the underlying reasons and the implementation of preventive measures. In this case report, we will report a patient who has encountered ulcerative colitis related to mononeuritis multiplex.