1/4. Invasive enteritis by strongyloides stercoralis presenting as acute abdominal distress under corticosteroid therapy.Overwhelming helminthiasis is still a problem in endemic areas, especially in immunocompromised patients. We report a case of invasive intestinal strongyloidiasis that was clinically expressed as acute abdominal distress in a 73-year-old man from Sao Paulo who had been receiving methylprednisone, 20 mg/day, for one year for osteoarthritis. A surgical specimen from the ileum revealed invasive enteritis with severe infestation by strongyloides stercoralis. The patient died of sepsis 6 days after surgery. The possibility of invasive strongyloidiasis should be considered in the differential diagnosis of acute abdominal distress in patients undergoing immunosuppressive therapy.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/4. Non-steroidal anti-inflammatory drug (NSAID)-induced colonic strictures and perforation: a case report.Although non-steroidal anti-inflammatory drug-induced colopathy is well described, colonic perforations complicating non-steroidal anti-inflammatory drug intake are rare. We report a patient with rheumatoid arthritis who was on long-term diclofenac and presented with early colonic stricture formation and a caecal perforation, which to the best of our knowledge, has only been reported once before. It is important to suspect this diagnosis in patients on non-steroidal anti-inflammatory drug therapy who present with an acute abdomen.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
3/4. Thoracoabdominal radiculopathy.Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in all patients showed changes consistent with an acute radiculopathy. All patients responded to anti-inflammatory therapy in combination with phenytoin, carbamazepine, amitriptyline, or local nerve block. TNRD is a condition that may be diagnosed earlier if clinical suspicion is increased, thus sparing patients excessive testing and surgery, and affording quicker relief.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
4/4. Acute abdomen in rheumatoid arthritis due to mesenteric arteritis. A case report and review.A 69-year-old woman with seropositive rheumatoid arthritis since the age of 54 developed severe abdominal pain, and laparotomy was performed. Due to perforation of the ileum, there was generalised peritonitis. The histological examination showed mesenteric rheumatoid arteritis. Only a few cases like this are described in the literature. Most of the patients were males, and the mortality was high. When a patient with rheumatoid arthritis develops abdominal pain, mesenteric arteritis may be the cause. No definitive therapy is available, but prompt surgical intervention followed by anticoagulants has been recommended. For the treatment of rheumatoid vasculitis as such, corticosteroids in high doses, cyclophosphamide and plasma exchange have been used separately with beneficial effects.- - - - - - - - - - ranking = 6keywords = arthritis (Clic here for more details about this article) |