| Gastrointestinal and hepatic manifestations of rheumatoid arthritis. | |
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MedLine Citation:
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PMID: 21203902 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Rheumatoid arthritis (RA), characterized by inflammation of the synovium and surrounding structures, has a prevalence of 0.5-1%. Rheumatoid vasculitis (RV) is an inflammatory condition of the small- and medium-sized vessels that affects up to 5% of patients with RA with intestinal involvement in 10-38% of these cases. Clinically apparent RV of the gastrointestinal (GI) tract, while rare, is often catastrophic, resulting in ischemic ulcers and bowel infarction. Vasculitis of the colon may present as pancolitis clinically similar to ulcerative colitis. Rectal biopsies that include submucosal vessels are positive for vasculitis in up to 40% of cases. Abnormal esophageal motility in RA may result in heartburn and dysphagia. Chronic atrophic gastritis may be associated with hypergastrinemia and hypo- or achlorhydria, promoting small bowel bacterial overgrowth. RA is the most common cause of secondary amyloidosis with GI symptoms in 22% of affected patients. Although amyloid is usually found in the liver, it is rarely evident clinically. Felty's syndrome occurs in less than 1% of patients with RA and is characterized by neutropenia and splenomegaly. The liver may be involved with portal fibrosis or nodular regenerative hyperplasia. Liver histology is abnormal in 92% of RA patients at autopsy, although the changes are usually mild without associated hepatomegaly. Drug-induced liver disease may occur with aspirin, sulfasalazine, and methotrexate. Significant liver damage is rare if the drug is discontinued or the patient is properly monitored. RA can affect both the GI tract and the liver; changes are usually mild except with RV. |
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Authors:
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Ellen C Ebert; Klaus D Hagspiel |
Publication Detail:
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Type: Journal Article Date: 2011-01-04 |
Journal Detail:
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Title: Digestive diseases and sciences Volume: 56 ISSN: 1573-2568 ISO Abbreviation: Dig. Dis. Sci. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7902782 Medline TA: Dig Dis Sci Country: United States |
Other Details:
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Languages: eng Pagination: 295-302 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA, jeydels@yahoo.com. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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