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Diverticulosis--a primary cause of life-threatening complications in rheumatoid arthritis
1Rheumatism Foundation Hospital, Heinola, Finland.
Objective:
To assess the role of complicated diverticular disease as a cause of death in rheumatoid arthritis (RA).
Methods:
In 1989 there were in Finland 1,666 deaths in subjects entitled to specially reimbursed medication for RA under the nationwide sickness insurance scheme. A retrospective clinical study was performed on these cases.
Results:
In 12 subjects, four males and eight females, the underlying cause of death was diverticular disease; the expected number was two. The mean age at death was 74 years in males and 80 years in females. The duration of RA ranged from 4 to 22 years (mean 13 years). In none of these cases was the death connected in the death certificate to RA or its treatment, yet all the subjects had been taking antirheumatic medication, usually two or three different drugs, at the time of death.
Conclusion:
Complicated diverticular disease, probably related to antirheumatic medication, is a more important cause of death in patients with RA than is generally recognized.