Small-bowel Involvement of Connective Tissue Diseases

초록

Involvements of connective tissue diseases (CTDs) are not common in clinical practice, and most of the symptoms are non-specific and often overlooked. In the case of gastrointestinal (GI) anomalies associated with CTD, three etiologies can be considered. First, excessive accumulation of collagen in the submucosal tissue of the intestine, bowel wall fibrosis, and muscle atrophy can lead to GI motility disorders. Second, arteritis or vasculitis may involve the small intestine. In this case, mucosal erosion and ulceration may occur, and, although rare, small-intestinal ischemia or necrosis occurs depending on the size of the affected blood vessels (Table 1). Finally, even if CTD does not directly involve the GI tract, GI symptoms caused by non-steroidal anti-inflammatory drugs (NSAIDs) or steroids used for the treatment of CTD may develop. GI involvement due to collagen accumulation occurs mainly in scleroderma and dermatomyositis, whereas vasculitis-induced GI disturbances may occur in systemic lupus erythematosus (SLE), rheumatoid arthritis, and polyarteritis nodosa. It is not uncommon for those two causes to overlap (Table 2). © Springer Nature Singapore Pte Ltd. 2022.