J Korean Rheum Assoc.  1999 Sep;6(3):247-252.

A Case of Intractable Diarrhea Associated with Early Onset Secondary Amyloidosis in Rheumatoid Arthritis

• Noh SM
• Kim CK
• Song YH
• Jung JH
• Chang HK
• Kim TH
• Jun JB
• Jung SS
• Lee IH
• Bae SC
• Yoo DH
• Kim SY

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.

Keyword

Rheumatoid arthritis; Amyloidosis; Intractable diarrhea

MeSH Terms

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
Amyloid
Antidiarrheals
C-Reactive Protein
Octreotide