Rheumatic features of gastrointestinal tract, hepatic, and pancreatic diseases

Rheumatic manifestations of diseases primarily of the gastrointestinal tract, liver, or pancreas are frequent and vary from soft tissue rheumatism and carpal tunnel syndrome to Raynaud's phenomenon, osteoporosis, arthritis, and vasculitis. Some patients with celiac disease develop osteoporosis and arthritis responsive to a gluten-free diet. It seems that osteoporosis is a frequent feature in patients with inflammatory bowel disease, and steroid use is an important risk factor. The use of steroids in patients with Crohn's disease and ulcerative colitis has generated medicolegal questions. This year a wealth of information has been published regarding hepatitis C virus infection. Arthritis, myopathy, and antibody production are some of the reported manifestations of chronic hepatitis C virus infection. There is evidence that may link chronic hepatitis C virus infection with the antiphospholipid syndrome.