A Case of Intractable Diarrhea Associated with Early Onset Secondary Amyloidosis in Rheumatoid Arthritis.
- Author:
Sung Min NOH
1
;
Chae Kyu KIM
;
Yong Ho SONG
;
Ja Hun JUNG
;
Hyun Kyu CHANG
;
Tae Hwan KIM
;
Jae Bum JUN
;
Sung Soo JUNG
;
In Hong LEE
;
Sang Cheol BAE
;
Dae Hyun YOO
;
Seong Yoon KIM
Author Information
1. The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Rheumatoid arthritis;
Amyloidosis;
Intractable diarrhea
- MeSH:
Abdominal Pain;
Aged;
Amyloid;
Amyloidosis*;
Antidiarrheals;
Arthritis;
Arthritis, Rheumatoid*;
C-Reactive Protein;
Diarrhea*;
Female;
Ganglion Cysts;
Hemorrhage;
Humans;
Incidence;
Myenteric Plexus;
Octreotide;
Parenteral Nutrition, Total;
Ulcer
- From:The Journal of the Korean Rheumatism Association
1999;6(3):247-252
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Amyloidosis is a disease that characterized by accumulation of an amorphous, proteinaceous materials in the various tissues and organs, but its origin is unknown. Recent clinical study showed that incidence of amyloidosis in rheumatoid arthritis was near 10% to 21%. Secondary amyloidosis is caused by accumulation of serum amyloid. A which is doing the acute phase behavior faster than C reactive protein. Symptoms of amyloidosis are various according to the involved organ. Gastrointestinal symptoms are obstruction, ulcer, malabsorption, and bleeding. Diarrhea is very intractable with the conventional antidiarrheal agent, the mechanism of that is infiltration of amyloid material in the intestinal myenteric plexus, sympathetic nerve and ganglion. We report a case of 65 years old woman with rheumatoid arthritis presented with abdominal pain, intractable diarrhea which was not controlled by antidiarrheal agents. Duration of arthritis is only 2 years. Immunohistochemical stain showed AA type which meant secondary form. We treated with Octreotide analogue and total parenteral nutrition for chronic diarrhea.
