Recurrent ischemic colitis in a patient with malignant rheumatoid arthritis (MRA)
H. Umehara1, Y. Mizumoto2, S. Yoshii3
(1) Department of Internal Medicine, Osaka Dental University, 8-1 Kuzuha Hanazono-cho, Hirakata 573-1121, Japan
(2)Kyoto National Hospital, Kyoto, Japan
(3)Ooba Hospital, Kyoto, Japan
Abstract A 63-year-old male with a 5-year history of malignant rheumatoid arthritis (MRA) developed recurrent massive melena and abdominal pain. Methylprednisolone pulse therapy and high doses of oral prednisolone markedly improved the clinical symptoms and normalized immunological disorders. However, he died of disseminated intra-vascular coagulation secondary to pneumonia caused by methicillin-resistant Staphylococcus aureus. Although a high dose of glucocorticoid therapy is effective for ischemic colitis complicated with MRA, intensive care to avoid any opportunistic infection is required.
