title: Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency.
abstract: 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.
authors.affiliation: Department of Internal Medicine, National Nagasaki Medical Center, 1001-1 Kubara, Omura, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Asada
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Saburo
authors.initials: S
authors.lastname: Shikuwa
authors.forename: Chun Yang
authors.initials: CY
authors.lastname: Wen
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Fukuda
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazato
authors.forename: Kenta
authors.initials: K
authors.lastname: Okamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Yohei
authors.initials: Y
authors.lastname: Mizuta
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; C050574:6-methylprednisone; D011239:Prednisolone; D011241:Prednisone