[Complications of colonic diverticular disease during rheumatoid polyarthritis: 7 cases].
BACKGROUND
Among the gastrointestinal adverse effects of nonsteroidal anti-inflammatory drugs (NSAID) and corticoids are mentioned complications of colonic diverticular disease. However, very few studies have described their consequences in rheumatoid arthritis.


METHODS
We report on seven patients who were admitted in our department between 1984 and 1997. All patients received corticoids and another antirheumatic drug (gold salts, hydroxychloroquine, immunosuppressive drugs); treatment also included NSAID in four cases. Two patients had a necrotizing vasculitis accompanying rheumatoid arthritis. Intestinal accompanying diseases were the following: one diverticulitis, three colonic perforations with pelviperitonitis, one colovesical fistula, one pelvic abscess, and one diverticular hemorrhage. All patients underwent surgery with positive results.


CONCLUSIONS
Combination of the four following symptoms: fever, abdominal pain, diarrhea, and hemorrhage, can uncover a complication of colónic diverticular disease occurring in the course of rheumatoid arthritis. It should be investigated, even if no history of diverculosis may be evidenced.
Durieux
S
S
Service de rhumatologie, hôpital de la Pitié-Salpêtrière, Paris, France.
Rozenberg
S
S
Bourgeois
P
P
D000038:Abscess / Q000139:chemically induced; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D003108:Colonic Diseases / Q000139:chemically induced; D004239:Diverticulitis, Colonic / Q000139:chemically induced*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006886:Hydroxychloroquine / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007412:Intestinal Fistula / Q000139:chemically induced; D007416:Intestinal Perforation / Q000139:chemically induced; D008875:Middle Aged; D050607:Organogold Compounds; D010388:Pelvis; D010538:Peritonitis / Q000139:chemically induced; D010488:Polyarteritis Nodosa / Q000150:complications; D001747:Urinary Bladder Fistula / Q000139:chemically induced
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D050607:Organogold Compounds; D006886:Hydroxychloroquine