Recurrent Stenosis of the Ileum Caused by Rheumatoid Vasculitis

Intern Med. 2016;55(7):819-23. doi: 10.2169/internalmedicine.55.5791. Epub 2016 Apr 1.

Abstract

A 65-year-old man with a 20-year history of rheumatoid arthritis was transferred to our hospital due to a second episode of intestinal obstruction, a fever, and joint pain within the previous 6 months. He had an extremely high rheumatoid factor level and decreased complement levels. Abdominal computed tomography, a small bowel series, and small intestinal endoscopy revealed severe ileal stenosis. Resection of the stenotic lesion was performed, and a histopathological examination revealed vasculitis. Rheumatoid vasculitis was diagnosed, and the patient began treatment with prednisolone and methotrexate, which improved his condition. Rheumatoid vasculitis is a rare, but possible cause of recurrent bowel obstruction.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / complications*
  • Constriction, Pathologic / etiology*
  • Constriction, Pathologic / surgery
  • Endoscopy, Gastrointestinal
  • Humans
  • Ileum / pathology*
  • Ileum / surgery
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery
  • Male
  • Methotrexate / therapeutic use
  • Prednisolone / therapeutic use
  • Rheumatoid Factor / blood
  • Rheumatoid Vasculitis / drug therapy
  • Rheumatoid Vasculitis / physiopathology*

Substances

  • Rheumatoid Factor
  • Prednisolone
  • Methotrexate