| Gastrointestinal tract involvement in polyarteritis nodosa and Churg-Strauss syndrome. | |
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MedLine Citation:
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PMID: 7653948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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L Guillevin; F Lhote; V Gallais; B Jarrousse; I Royer; M Gayraud; J Benichou |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annales de m?decine interne Volume: 146 ISSN: 0003-410X ISO Abbreviation: Ann Med Interne (Paris) Publication Date: 1995 |
Date Detail:
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Created Date: 1995-09-28 Completed Date: 1995-09-28 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0171744 Medline TA: Ann Med Interne (Paris) Country: FRANCE |
Other Details:
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Languages: eng Pagination: 260-7 Citation Subset: IM |
Affiliation:
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Service de M?decine Interne, H?pital Avicenne, Bobigny. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 5536-17-4/Vidarabine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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