Year 2020 / Volume 112 / Number 12
Digestive Diseases Image
Gastrointestinal and renal involvement in systemic vasculitis

952-953

DOI: 10.17235/reed.2020.6965/2020

João Carlos Silva, Marina Reis, Antónia Furtado, Carlos Fernandes,

Abstract
Vasculitis can also present with GI or solid organ involvement. IgA and ANCA associated vasculitis are more likely to have GI involvement. A 56-year-old female was admitted to the ER due to nausea, vomiting, epigastric pain and fever. The patient had a medical history of acromegaly and chronic kidney disease of an undetermined etiology, elevated C-reactive protein and renal dysfunction. Abdominal-CT revealed duodenal parietal thickening and pancreatic head edema. On esophagogastroduodenoscopy (EGD), duodenal mucosa had a diffusely nodular aspect with ulcerated areas. The following differential diagnosis were made, infectious enteritis, Whipple disease, infiltrative disorder and GI vasculitis. After discussion between a multidisciplinary team of Gastroenterology and Nephrology, they decided to initiate oral glucocorticoids due to worsening of the renal function, which lead to the resolution of digestive symptoms and renal function stabilization. Myeloperoxidase antineutrophilic-cytoplasmic antibodies (MPO-ANCA) were subsequently positive and histology confirmed duodenal involvement by vasculitis. The patient was asymptomatic after 4-weeks, with endoscopic healing and renal function stabilization. GI involvement limited to the duodenum in the setting of ANCA-MPO vasculitis is a rare condition. Moreover, histopathologic confirmation of vasculitis in endoscopic biopsy samples is exceptional.
Share Button
New comment
Comments
No comments for this article
References
Hatemi, I., G. Hatemi, and A.F. Celik, Systemic vasculitis and the gut. Curr Opin Rheumatol, 2017. 29(1): p. 33-38.
Pagnoux, C., Mahr, A., Cohen, P., et al., Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis. Medicine (Baltimore), 2005. 84(2): p. 115-28.
Silva, J.C., Silva, A. P., Furtado, A., et al., Colon-Limited Leukocytoclastic Vasculitis. Am J Gastroenterol, 2018. 113(8): p. 1114.
Related articles
Citation tools
Silva J, Reis M, Furtado A, Fernandes C. Gastrointestinal and renal involvement in systemic vasculitis. 6965/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 423 visits.
This article has been downloaded 240 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 11/02/2020

Accepted: 02/03/2020

Online First: 23/11/2020

Published: 09/12/2020

Article revision time: 16 days

Article Online First time: 286 days

Article editing time: 302 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology