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Abstract

SummaryAim: The aim of this study was to determine the prevalence and mortality of gastric (gU) and duodenal (dU) peptic ulcers in rheumatoid arthritis (RA). Also, to evaluate the possible relationship between gU and dU and autoimmune vasculitis (A-SV), AA amyloidosis (AAa) or lethal septic infection (SI) with or without purulent arthritis (PA). Patients and Methods:A randomized autopsy population of 234 in-patients with RA was studied. RA was confirmed clinically according to the criteria of the ACR.The presence of gU and dU, A-SV, AAa, SI, or PA was determined at autopsy and supported by histological examination. The relationships between prevalence and mortality of gU or dU and A-SV, AAa, SI or PA were analyzed by Pearson's chi-squared (χ 2 ) test.Results and Conclusions: gU was found in 11 (4.70%), dU in 9 (3.85%), A-SV in 47 (20.08%), AAa in 48 (20.51%), and SI in 31 (13.24%), accompanied with PA in 15 (6.41%) of 234 patients. The negative correlation between A-SV, AAa, or PA and prevalence of gU or dU suggests that -in our autopsy population -A-SV, AAa or PA had no pathogenic role in development of gastric or duodenal ulcers. A-SV, AAa or PA not influenced the mortality of gU or dU. Gastric or duodenal ulcers can be regarded as associated diseases of RA and not as complications of it. The significant connection between SI and prevalence and mortality of gU or dU indicates a causal relationship between them: the development of gU or dUs increase the risk of lethal SI. The aim of this study was to determine the prevalence and mortality of gU and dU in RA. Also, to identify the possible role of systemic autoimmune vasculitis (A-SV) or AA amyloidosis (AAa) in the prevalence and mortality of gU and dU, furthermore to evaluate the possible relationship between gU and dU and lethal septic infection (SI) with or without purulent arthritis (PA). The basic disease, its complication(s), and the lethal outcome caused by gU and dU were determined and analyzed retrospectively, reviewing the clinical and pathological reports. The presence of gU or dU and A-SV, AAa furthermore SI (with or without PA) was determined at autopsy and confirmed by a detailed review of extensive histological material. From each patient 50-100 tissue blocks of 12 organs (heart, lung, liver, spleen, kidneys, pancreas, gastrointestinal tract, adrenal glands, skeletal muscle, peripheral nerve, skin and brain) were studied microscopically [13]. Keywords: Patients and Methods Prevalence and Mortality of Gastric and Duodenal Ulcers in Rheumatoid Arthritis -A Retrospective Clinicopathologic Study of 234 Autopsy Patients 2/9Copyright: ©2017 Bély et al. Results gU was found in 11 (4.70%), and dU in 9 (3.85%) of 234 RA patients (Figure 1.1). Seven gU of 11, and 6 dU of 9 led to death in 13 (65.0 %) of 20 patients (Figure 1.2). In 4 patients (in 2 with gU and in 2 with dU) the direct cause of death was massive internal bleeding, and in 3 (in 2 with gU and in 1 with dU) it was perforation of an ulcer accompanied by peritonitis. Perforated gU (n=3 of 11) an...