Journal List > J Rheum Dis > v.21(5) > 1064135

Song, Kim, Park, Yoo, Kim, Kang, and Yoo: Localized Mesenteric Vasculitis in a Patient with Polymyalgia Rheumatica

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.

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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.
jrd-21-253f1.tif
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.
jrd-21-253f2.tif
Figure 3.
Aorta CT. There was no evidence of vasculitis in aorta and its major branches.
jrd-21-253f3.tif
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