J Rheum Dis.  2014 Oct;21(5):253-256. 10.4078/jrd.2014.21.5.253.

Localized Mesenteric Vasculitis in a Patient with Polymyalgia Rheumatica

• Song ST
• Kim Y
• Park CK
• Yoo SJ
• Kim JH
• Kang SW
• Yoo IS

• KMID: 2222949
• DOI: http://doi.org/10.4078/jrd.2014.21.5.253

Abstract

Polymyalgia rheumatica (PMR) is an uncommon disorder characterized by bilateral pain and stiffness in the shoulder and pelvic girdles. Polymyalgia rheumatica and giant cell arteritis (GCA) occur in the same patient population and share a common pathogenesis. Giant cell arteritis predominantly affects the cranial arteries and rarely involves the gastrointestinal tract. Moreover, giant cell arteritis has rarely been reported in Asians. Here, we present a case with 62-year-old Asian woman who developed polymyalgia rheumatica with localized vasculitis in the mesenteric arteries.

Keyword

Gastrointestinal tract; Mesenteric vasculitis; Polymyalgia rheumatica

MeSH Terms

Arteries
Asian Continental Ancestry Group
Female
Gastrointestinal Tract
Giant Cell Arteritis
Humans
Mesenteric Arteries
Middle Aged
Polymyalgia Rheumatica*
Shoulder
Vasculitis*

Figure

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  Figure 1. Abdomen and pelvis CT. (A) Diffuse severe edematous wall thickening in distal ileum and ileocecal region with luminal collapse (arrow). (B) Vascular congestion seen in the mesenteric vessels (arrow), suggesting ischemic bowel disease due to vasculitis.

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  Figure 2. (A, B) Follow-up CT scan after Steroid and MTX therapy shows improved bowel wall thickening and engorged vasa recta of adjacent small bowel mesentery.

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  Figure 3. Aorta CT. There was no evidence of vasculitis in aorta and its major branches.

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