title: Nonsteroidal antiinflammatory drug-induced enteropathy and severe chronic anemia in a patient with rheumatoid arthritis.
abstract: This report describes the case of a woman who was admitted to the hospital with severe anemia and refractory rheumatoid arthritis. She had been transfusion dependent for 8 years and was receiving a combination of indomethacin and naproxen. An indium-111 white blood cell scan revealed small bowel inflammation. Salsalate was substituted for her previous nonsteroidal antiinflammatory drugs (NSAIDs), and metronidazole was initiated. This resulted in maintenance of a normal hemoglobin level for at least 1 year after discharge. Small intestine inflammation and bleeding (enteropathy) due to NSAIDs must be considered in the evaluation of anemia in patients with arthritis.
authors.affiliation: Division of Rheumatology, University of Alberta, Edmonton, Canada.
authors.forename: N M
authors.initials: NM
authors.lastname: Davies
authors.forename: F
authors.initials: F
authors.lastname: Jamali
authors.forename: K J
authors.initials: KJ
authors.lastname: Skeith
mesh_terms: D000368:Aged; D000740:Anemia / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002908:Chronic Disease; D004751:Enteritis / Q000139:chemically induced*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal