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All of the authors confirm that there is no conflict of interest with regard to this work.

Fig. 1
Abdominal X-ray/CT on admission. The intestine and colon were markedly dilated, and paralytic ileus was diagnosed.

Fig. 2
a-c Hepatobiliary scintigraphy before IVCY. RI excretion from the liver parenchyma was markedly reduced. Gallbladder ejection fraction (GBEF) 30: 4%, showing a marked reduction (normal: 40% or higher)
d-f Hepatobiliary scintigraphy after IVCY. RI was excreted from the liver parenchyma. GBEF30: 40%, showing improvement

Fig. 3
Clinical Course.
PSL, prednisolone; mPSL, methylprednisolone; IVCY, intravenous cychlophosphamide; PE, plasma exchange

Table 1
Reported cases of SLE with pan-dysautonomia.
PSL, prednisolone; mPSL, methylprednisolone; IVCY, intravenous; AZA, azathioprine; HCQ, hydroxychloroquine; N.S, not showed