Ulcerative Enteropathy in Patients with Rheumatoid Arthritis Hiroyuki Kobayashi 1 , Tadahiko Fuchigami 1 , Shigeru Nishiki 2 1Institute of Gastroenterology, Matsuyama Red Cross Hospital 2Department of Internal Medicine, Ehime Seikyo Hospital Keyword: 慢性関節リウマチ , 腸潰瘍 , 縦走潰瘍 , 虚血性腸炎 , 血管炎 pp.1247-1256
Published Date 1991/11/25
DOI https://doi.org/10.11477/mf.1403102686
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 We investigated the clinical and histological features of five patients with rheumatoid arthritis, who manifested ulcerative enteropathy other than gastrointestinal amyloidosis.

 Four patients were affected in the left side of the colon, while the other in the terminal ileum. The sigmoid colon was involved in each patient with colonic involvement. Multiple ulcers were found in four patients. The ulcerative lesions, with or without aphthoid or round ulcers, had morphologically common characteristics, viz. longitudinal ulcers, sharply demarcated from the surrounding mucosa, which was normal in appearance.

 Histologically, the existence of vasculitis was confirmed in the resected terminal ileum of one patient (case 5), while the histology of one colonic lesion (case 4) was compatible with that in ischemic colitis.

 Although the etiology of colonic lesions in the remaining three patients is still obscure, we consider that these lesions may have been caused by chronic microcirculatory disturbance in the submucosal vessels around the ulcers. We say this because the clinical and morphological features of our patients had some similarities to ischemic disorders such as ischemic colitis, vasculitis (case 5) and intestinal Behçet disease.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


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