Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 28, 2006; 12(32): 5240-5243
Published online Aug 28, 2006. doi: 10.3748/wjg.v12.i32.5240
Development of ulcerative colitis during the course of rheumatoid arthritis: Association with selective IgA deficiency
Yuki Asada, Hajime Isomoto, Saburo Shikuwa, Chun Yang Wen, Eiichiro Fukuda, Masaru Miyazato, Kenta Okamoto, Takashi Nakamura, Hitoshi Nishiyama, Yohei Mizuta, Kiyoshi Migita, Masahiro Ito, Shigeru Kohno
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.

Keywords: Ulcerative colitis, Rheumatoid arthritis, Selective IgA deficiency