title: Mastocytic enterocolitis as a rare cause of chronic diarrhea in a patient with rheumatoid arthritis.
abstract: The prevalence of chronic diarrhea within the U.S. population has been reported to be as high as five per cent, and numerous causes have been identified. Especially in patients suffering from rheumatoid arthritis drug therapy should be considered as possible cause. We report a case of chronic diarrhea triggered by mastocytic enterocolitis in a patient suffering from rheumatoid arthritis. Systemic mastocytosis and other causes of chronic diarrhea, especially therapy with methotrexate, were carefully ruled out. Treatment with desloratadin and ranitidine was initiated and led to a rapid and persistent amelioration of clinical symptoms. The diagnosis of mastocytic enterocolitis should be considered in patients with chronic diarrhea and normal clinical, laboratory, as well as endoscopical work-up.
authors.affiliation: Department of Internal Medicine, State Hospital Mürzzuschlag, Mürzzuschlag, Austria. rene.thonhofer@pro.medunigraz.at
authors.forename: Rene
authors.initials: R
authors.lastname: Thonhofer
authors.forename: Cornelia
authors.initials: C
authors.lastname: Siegel
authors.forename: Markus
authors.initials: M
authors.lastname: Trummer
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D004359:Drug Therapy, Combination; D004760:Enterocolitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D017336:Loratadine / Q000031:analogs & derivatives; D008297:Male; D008407:Mast Cells / Q000187:drug effects / Q000473:pathology; D008415:Mastocytosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011899:Ranitidine / Q000627:therapeutic use; D053802:Tryptases / Q000032:analysis
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D039563:Histamine H1 Antagonists, Non-Sedating; D007073:Immunoglobulin E; D017336:Loratadine; D011899:Ranitidine; D053802:Tryptases; C121345:desloratadine; D008727:Methotrexate