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MR Vol.11 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.11 No.1 |
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Gastrointestinal disorder and Helicobacter
pylori infection in patients with rheumatoid arthritis |
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| Full Text (PDF) |
| H. Nakamura , E. Mukai2, D. Hirano2, T. Matsuhisa3,
N. Yamada4, S. Yoshino2 |
(1)Institute of Medical Science, St. Marianna
University, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8512, Japan
(2)Department of Joint Disease and Rheumatism, Nippon Medical School, Tokyo,
Japan
(3)Department of Gastrointestinal Endoscopy, Nippon Medical School, Tokyo,
Japan
(4)Department of Pathology, Nippon Medical School, Tokyo, Japan |
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| Abstract |
| Abstract Gastrointestinal disorders such as gastritis
and peptic ulceration are very common in patients with rheumatoid
arthritis. Helicobacter pylori appeared to be a high risk factor
for the development of peptic ulcers or chronic active gastritis.
Thus, the objective of this study is to elucidate gastrointestinal
findings and the prevalence of H. pylori in patients with rheumatoid
arthritis. Consecutive RA patients were recruited for this study,
irrespective of gastrointestinal symptoms. Routine endoscopy was
performed and mucosal specimens were analyzed according to the Sydney
system. H. pylori infection was determined histologically using H-E
staining, Wartin Starry silver staining, and immunohistochemistry.
Of 97 patients, only 16 had gastrointestinal symptoms. By endoscopic
examination, gastritis was observed in 39 patients (40.2%), gastric
ulcers in 24 patients (24.7%), and duodenal ulcers in 7 patients
(7.2%). The histological results analyzed by the Sydney system showed "inflammation," "active," and "atrophy" for
71.1%, 58.5%, and 54.6% of samples, respectively. Sixty patients
(61.9%) were infected by H. pylori, but the presence of H. pylori
did not increase the chance of endoscopic gastrointestinal disorders.
The presence of a rheumatoid factor was inversely related to H. pylori
infection, and the value of the rheumatoid factor was lower in patients
with the infection. In conclusion, it was found that H. pylori infection
was not a major cause of gastrointestinal disorders in RA, and that
the presence of rheumatoid factor significantly reduces the chance
of H. pylori infection. |
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| Key words |
| Key words Helicobacter pylori ・ Rheumatoid
arthritis ・ Sydney system |
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