Short-path arthritis-dermatitis syndrome
Intestinal short-circuit surgery (jejunoileal anastomosis) is a common treatment for morbid obesity, but it may cause arthritis-dermatitis syndrome, sometimes complicated by kidney, liver and blood system diseases. Arthritis symptoms occur in 20% to 80% of cases 2 to 30 months after surgery. This arthritis is multi-joint symmetrical and migratory, affecting both upper and lower limb joints. One-quarter of patients are chronically affected, and the duration of arthritis cannot be predicted. There is no correlation between joint symptoms and abnormal intestinal peristalsis. No radiographic deformity or erosion is seen; sacroiliac joint and spine involvement is uncommon. 66% to 80% of patients have a variety of skin abnormalities, and nodular erythema, macules, papular macules, pustular macules, urticaria and nodular dermatitis have all been reported. Other relevant clinical manifestations include Raynaud's phenomenon, paresthesia, pericarditis, pleurisy, glomerulonephritis, retinal vasculitis and superficial thrombophlebitis. Since 1952, some people have used intestinal short-circuit as a treatment for weight loss. Eleven years later, it was found that although this therapy achieved the goal of weight loss, it also often caused complications including malabsorption and joint symptoms.
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