Asada Y, Isomoto H, Shikuwa S, Wen CY, Fukuda E, Miyazato M, Okamoto K, Nakamura T, Nishiyama H, Mizuta Y, Migita K, Ito M, Kohno S. Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency. World J Gastroenterol 2006; 12(32): 5240-5243 [PMID: 16937542 DOI: 10.3748/wjg.v12.i32.5240]
Corresponding Author of This Article
Hajime Isomoto, MD, Second Department of Internal Medicine, Nagasaki University School of Medicine,1-7-1 Sakamoto, Nagasaki 852-8501, Japan. hajimei2002@yahoo.co.jp
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yuki Asada, Saburo Shikuwa, Eiichiro Fukuda, Masaru Miyazato, Kenta Okamoto, Takashi Nakamura, Kiyoshi Migita, Department of Internal Medicine, National Nagasaki Medical Center, 1001-1 Kubara, Omura, Japan
Chun Yang Wen, Masahiro Ito, Department of Pathology, National Nagasaki Medical Center, 1001-1 Kubara, Omura, Japan
Hajime Isomoto, Hitoshi Nishiyama, Yohei Mizuta, Shigeru Kohno, Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hajime Isomoto, MD, Second Department of Internal Medicine, Nagasaki University School of Medicine,1-7-1 Sakamoto, Nagasaki 852-8501, Japan. hajimei2002@yahoo.co.jp
Telephone: +81-95-8497281 Fax: +81-95-8497285
Received: January 24, 2006 Revised: July 15, 2006 Accepted: July 20, 2006 Published online: August 28, 2006
Abstract
A 56-year-old woman with a 29-year history of rheumatoid arthritis (RA) was admitted to the hospital, complaining of high fever, abdominal pain and severe bloody diarrhea. Colonoscopy revealed friable and edematous mucosa with spontaneous bleeding, diffuse erosions and ulcers extending from the rectum to the distal transverse colon. Histopathological findings of rectal biopsies were compatible with ulcerative colitis (UC). Being diagnosed as having severe active left-side UC, she was successfully treated with intravenous methylprednisolone followed by prednisolone and leukocytapheresis. Laboratory tests revealed low serum and saliva IgA levels, which might play a role in the development of UC. To our knowledge, this is the first case of UC occurring during the course of RA, accompanied by selective IgA deficiency.
