pancreatitis or gastric ulcer, both of which may occur from the disease or secondary to medical therapy Malabsorption syndrome may be a manifestation of SLE When accompanied by melena, it suggests poorly controlled disease complicated by GI vasculitis This is associated with a 50% mortality rate without expeditious evaluation and treatment Of course, abdominal pain in SLE is not always related to the underlying disease but may stem from other causes, including appendicitis, ruptured ovarian cyst, or pelvic inflammatory disease Further complicating evaluation is the fact that manifestations of any of these conditions may be masked or altered by the corticosteroids and immunosuppressive agents most patients receive Mild to moderate anemia is common in SLE Hemolytic anemia associated with a positive Coombs test is most characteristic An acute decrease in the hemoglobin or hematocrit should alert the physician to the possibility of internal hemorrhage or massive hemolysis Autoimmune thrombocytopenia, even in the absence of offending drugs, is commonly seen in SLE; up to 20% of adults initially diagnosed with idiopathic thrombocytopenic purpura (ITP) progress to full-blown lupus over the ensuing years Leukopenia and lymphopenia are additional hematologic abnormalities characteristically seen in SLE; apart from viral infections and drug toxicity, few other conditions cause children’s lymphocyte counts to fall to