JRD Journal of Rheumatic Diseases J Rheum Dis 2093-940X 2233-4718 The Korean College of Rheumatology 10.4078/jrd.2014.21.5.253 jrd-21-253 Case Report Localized Mesenteric Vasculitis in a Patient with Polymyalgia Rheumatica SongSeung Taek KimYoung ParkChan Keol YooSu Jin KimJin Hyun KangSeong Wook YooIn Seol Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea Corresponding to: In Seol Yoo, Department of Internal Medicine, Chungnam National University School of Medicine, 640, Deasa-dong, Jung-gu, Daejeon 301-721, Korea. E-mail: cptmiller@cnuh.co.kr 10 2014 31 10 2014 21 5 253 256 23082013 14102013 16102013 Copyright © 2014 The Korean College of Rheumatology 2014 This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited. 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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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.

(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.

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