Document Detail


Gastrointestinal tract involvement in polyarteritis nodosa and Churg-Strauss syndrome.
MedLine Citation:
PMID:  7653948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the nature and incidence of gastrointestinal (GI) manifestations in polyarteritis nodosa (PAN) and Churg-Strauss syndrome (CSS) and define their therapeutic and prognostic implications. METHODS: Fifty-three patients (29 males, 24 females) affected with PAN or CSS and followed in our institution were included in a retrospective study. Patients were divided into 2 groups: patients without GI manifestations (group A) and patients with GI manifestations (group B). Among patients with GI manifestations we have studied a subgroup with a possibly poorer prognosis in whom the following symptoms were present: GI tract hemorrhage, intestinal perforation, digestive tract surgery due to PAN manifestations, intractable abdominal pain and weight loss greater than 20% of normal weight due to GI tract ischemia. RESULTS: The clinical manifestations were those that are classically encountered in PAN and CSS. Every patient fulfilled the American College of Rheumatology (ACR) criteria for PAN and CSS. Thirty-five patients without GI manifestations were included in group A and 18 patients (34%) with GI manifestations in group B. The mean age of the group at the time of diagnosis was 56.9 +/- 19.1 years (range: 21-71 years) in group A and 47.5 +/- 16.8 years (range: 12-82) in group B. GI manifestations were considered as one of the symptoms revealing PAN in 7 (13.2%) cases. Six of the 18 patients with GI manifestations had definite organ involvement related to vasculitis. Abdominal pain without characteristic organ involvement or surgical emergency was present in 12/18 patients. HBV infection was more frequently observed in group B than in group A. Survival curves showed that at 10 years, 80% of the patients in group A were alive versus 67% in group B (P not significant). For the 9 patients with severe GI manifestations, the survival curves showed that, at 10 years, 44% of them were alive versus 80% in the other group A (p < 0.001). CONCLUSIONS: GI manifestations are frequent in PAN and CSS and were present in 34% of our patients. Prognosis of PAN with GI manifestations is not statistically different than in PAN without GI involvement, except for patients with severe digestive complications.
Authors:
L Guillevin; F Lhote; V Gallais; B Jarrousse; I Royer; M Gayraud; J Benichou
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annales de m?decine interne     Volume:  146     ISSN:  0003-410X     ISO Abbreviation:  Ann Med Interne (Paris)     Publication Date:  1995  
Date Detail:
Created Date:  1995-09-28     Completed Date:  1995-09-28     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0171744     Medline TA:  Ann Med Interne (Paris)     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  260-7     Citation Subset:  IM    
Affiliation:
Service de M?decine Interne, H?pital Avicenne, Bobigny.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cause of Death
Churg-Strauss Syndrome / complications*,  physiopathology,  therapy
Cyclophosphamide / therapeutic use
Female
Gastrointestinal Diseases / etiology*,  physiopathology,  therapy
Humans
Male
Middle Aged
Plasma Exchange
Polyarteritis Nodosa / complications*,  physiopathology,  therapy
Prednisone / therapeutic use
Prognosis
Retrospective Studies
Vidarabine / therapeutic use
Chemical
Reg. No./Substance:
50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 5536-17-4/Vidarabine

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