Recurrent Stenosis of the Ileum Caused by Rheumatoid Vasculitis

A 65-year-old man with a 20-year history of rheumatoid arthritis was transferred to our hospital due to a second episode of intestinal obstruction, a fever, and joint pain within the previous 6 months. He had an extremely high rheumatoid factor level and decreased complement levels. Abdominal comput...

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Bibliographic Details
Published in:Internal Medicine 2016, Vol.55(7), pp.819-823
Main Authors: Tago, Masaki, Naito, Yuka, Aihara, Hiroki, Furukawa, Naoko E., Yamashita, Shu-ichi
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - complications
Constriction, Pathologic - etiology
Constriction, Pathologic - surgery
Endoscopy, Gastrointestinal
Humans
Ileum - pathology
Ileum - surgery
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
low complement value
Male
Methotrexate - therapeutic use
Prednisolone - therapeutic use
recurrent intestinal obstruction
Rheumatoid Factor - blood
rheumatoid vasculitis
Rheumatoid Vasculitis - drug therapy
Rheumatoid Vasculitis - physiopathology
stenosis of ileum
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Summary:A 65-year-old man with a 20-year history of rheumatoid arthritis was transferred to our hospital due to a second episode of intestinal obstruction, a fever, and joint pain within the previous 6 months. He had an extremely high rheumatoid factor level and decreased complement levels. Abdominal computed tomography, a small bowel series, and small intestinal endoscopy revealed severe ileal stenosis. Resection of the stenotic lesion was performed, and a histopathological examination revealed vasculitis. Rheumatoid vasculitis was diagnosed, and the patient began treatment with prednisolone and methotrexate, which improved his condition. Rheumatoid vasculitis is a rare, but possible cause of recurrent bowel obstruction.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.5791