The present study was carried out on 29 patients with collagen diseases including 16 with rheumatoid arthritis, 8 patients with systemic lupus erythematosus and 5 patients with systemic sclerosis.
Colonoscopic examination showed that abnormal findings were detected in 9 patients [31%] [one with rheumatoid arthritis, 5 with SLE and 3 with systemic sclerosis] . Diverticulosis and polyps were only seen in systemic sclerosis, whereas, hyperemia and erosion of the colonic mucosa predominated in SLE. On histopathological examination of mucosal specimens, it was apparent that stromal edema was most marked in patients with SLE [occurred in 6 cases] . The same was true for basement membrane thickening which was observed in 2 cases. On the other hand, vessel congestion was most marked in systemic sclerosis. Vasculitis was observed in 2 cases [one with SLE and the other with rheumatoid arthritis] . Stromal hemorrhage occurred in 2 cases with systemic sclerosis [one case with SLE and 4 cases with rheumatoid arthritis] . Results of the present study showed that rheumatoid factor was detected in 6 out of the 10 cases with vessel congestion, the anti-DNA was detected in 4 cases and antinuclear antibody was detected in only 2 cases. Stromal hemorrhage was related more to the antinuclear antibody and stromal edema was related more to rheumatoid factor and anti-DNA antibody. In conclusion, collagen diseases seem to have more widespread histopathological abnormalities that could be suggested by gastrointestinal clinical manifestations or the colonoscopic appearance. Possibly, these abnormalities are related to the type of circulating antibody or the antigen antibody complex deposited in the colonic mucosa
Reda Awadain ,
Colonic involvement in collagen diseases,
Med. J. Cairo Univ. 1994;
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