Life threatening gastrointestinal tract complications in a patient of rheumatoid arthritis. Is it drug or disease related?

Authors

  • Kanisha Shah Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India. Author
  • Sapna D. Gupta Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India. Author
  • Supriya D. Malhotra Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India. Author

DOI:

https://doi.org/10.53411/jpadr.2022.3.3.08

Keywords:

Gastrointestinal perforation, Rheumatoid Arthritis, Glucocorticoids

Abstract

Introduction: Gastrointestinal (GI) complications are very frequent and sometimes fatal in patients with Rheumatoid Arthritis (RA). Gastrointestinal perforation is a rare but serious event, most frequently involving the lower GIT, which has been observed in patients with RA.

Case Presentation: We present here an Adverse Drug Reaction (ADR) which is small bowel ischemia with perforation in a 61-year-old RA patient, who was taking a tablet of Prednisolone and tablet Hydroxychloroquine.

Discussion: Several studies indicated that RA patients may be at a higher risk of GI perforation. This could be attributed to the disease pathophysiology or the use of drugs for treatment like Glucocorticoids and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Rheumatologists must be vigilant for GI complications while prescribing anti-rheumatoid drugs.

Conclusion: GI perforations are rare events in RA patients, but cause significant morbidity and mortality. Increasing age and other comorbid conditions also increase the risk of adverse GI events.

Author Biographies

  • Kanisha Shah, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.

    Resident doctor, Department of Pharmacology.

  • Sapna D. Gupta, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.

    Associate Professor, Department of Emergency Medicine.

  • Supriya D. Malhotra, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.

    Professor and Head, Department of Pharmacology.

References

Berman, S., Bucher, J., Koyfman, A., & Long, B. J. (2018). Emergent Complications of Rheumatoid Arthritis. The Journal of emergency medicine, 55(5), 647–658.

Curtis, J. R., Lanas, A., John, A., Johnson, D. A., & Schulman, K. L. (2012). Factors associated with gastrointestinal perforation in a cohort of patients with rheumatoid arthritis. Arthritis care & research, 64(12), 1819–1828.

Curtis, J. R., Xie, F., Chen, L., Spettell, C., McMahan, R. M., Fernandes, J., & Delzell, E. (2011). The incidence of gastrointestinal perforations among rheumatoid arthritis patients. Arthritis and rheumatism, 63(2), 346–351.

Jagpal, A., & Curtis, J. R. (2018). Gastrointestinal Perforations with Biologics in Patients with Rheumatoid Arthritis: Implications for Clinicians. Drug safety, 41(6), 545–553.

Wang, W., Zhou, H., & Liu, L. (2018). Side effects of methotrexate therapy for rheumatoid arthritis: A systematic review. European journal of medicinal chemistry, 158, 502–516.

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Published

2022-09-01

How to Cite

Life threatening gastrointestinal tract complications in a patient of rheumatoid arthritis. Is it drug or disease related?. (2022). Journal of Pharmacovigilance and Drug Research, 3(3), 51-53. https://doi.org/10.53411/jpadr.2022.3.3.08

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