Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency.
A 56-year-old woman with a 29-year history of rheumatoid arthritis (RA) was admitted to the hospital, complaining of high fever, abdominal pain and severe bloody diarrhea. Colonoscopy revealed friable and edematous mucosa with spontaneous bleeding, diffuse erosions and ulcers extending from the rectum to the distal transverse colon. Histopathological findings of rectal biopsies were compatible with ulcerative colitis (UC). Being diagnosed as having severe active left-side UC, she was successfully treated with intravenous methylprednisolone followed by prednisolone and leukocytapheresis. Laboratory tests revealed low serum and saliva IgA levels, which might play a role in the development of UC. To our knowledge, this is the first case of UC occurring during the course of RA, accompanied by selective IgA deficiency.
Asada
Yuki
Y
Department of Internal Medicine, National Nagasaki Medical Center, 1001-1 Kubara, Omura, Japan.
Isomoto
Hajime
H
Shikuwa
Saburo
S
Wen
Chun Yang
CY
Fukuda
Eiichiro
E
Miyazato
Masaru
M
Okamoto
Kenta
K
Nakamura
Takashi
T
Nishiyama
Hitoshi
H
Mizuta
Yohei
Y
Migita
Kiyoshi
K
Ito
Masahiro
M
Kohno
Shigeru
S
D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007070:Immunoglobulin A / Q000378:metabolism; D007937:Leukapheresis; D008875:Middle Aged; D011239:Prednisolone / Q000494:pharmacology; D011241:Prednisone / Q000031:analogs & derivatives / Q000494:pharmacology
D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; C050574:6-methylprednisone; D011239:Prednisolone; D011241:Prednisone