Related Experiment Video

Updated: Jun 12, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

A case of emphysematous pyelonephritis in a patient with rheumatoid arthritis taking corticosteroid and low-dose

Hiroshi Watanabe1, Ryoma Suzuki, Tomoyuki Asano

  • 1Department of Gastroenterology and Rheumatology, School of Medicine, Fukushima Medical University, Fukushima, Japan. chiehiro@fmu.ac.jp

International Journal of Rheumatic Diseases
|June 12, 2010
PubMed

Insights

Rheumatoid arthritis patients face higher infection risks. This case highlights emphysematous pyelonephritis in a rheumatoid arthritis patient with AA amyloidosis and steroid-induced diabetes.

Area of Science:

  • Rheumatology
  • Nephrology
  • Endocrinology

Background:

  • Rheumatoid arthritis (RA) is a systemic autoimmune disease causing chronic synovial inflammation.
  • RA patients have an elevated risk of infections due to the disease and its treatments.
  • Corticosteroids and methotrexate are common RA medications.

Observation:

  • A case of emphysematous pyelonephritis was observed.
  • The patient had co-existing AA amyloidosis and steroid-induced diabetes mellitus.
  • The patient was undergoing treatment with corticosteroids and low-dose methotrexate.

Findings:

  • Emphysematous pyelonephritis is a severe kidney infection.
  • This rare complication occurred in an RA patient with multiple comorbidities.
  • The patient's complex medical profile likely contributed to the development of this infection.

Implications:

  • This case underscores the importance of vigilance for severe infections in RA patients.
  • It highlights potential complications arising from RA, its treatments, and comorbidities.
  • Clinicians should consider aggressive infection management in immunocompromised RA patients with diabetes and amyloidosis.

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Pulmonary Tuberculosis I01:29

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...