[Upper gastrointestinal tract lesions in rheumatoid arthritis]

We studied the upper gastrointestinal (GI) tract lesions by endoscopy, and evaluated the relationship between the lesions and clinical characteristics in 154 patients with rheumatoid arthritis (RA). Eighty-six (55.8%) had drug-induced ulcers and/or erosions, which were present mostly at the antrum as multiple lesions. A history of gastric ulcer, positive tests for fecal occult blood and progression of anemia were noticed more frequently in the patients with gastric ulcers and/or erosions, compared to those with normal mucosa. Indomethacin and prednisolone (15mg/day) were also used more frequently in the patients with gastric ulcers. Twelve patients showed amyloid depositions in the gastric mucosa, of which 8 patients had gastric ulcers and/or erosions. These results indicate that the incidence of GI tract lesions is significantly high in RA patients and that the endoscopic examination should be performed during the course of RA treatment.