Enterorrhagia Presented in Patient with Granulomatosis and Polyangitis - A Case Report
Journal
BANTAO
Date Issued
2022
Author(s)
Vesna Ristovska
Nikola Gjorgievski
Julijana Usprcov
Gabriela Dimova
DOI
https://www.bantaojournal.com/_files/ugd/356e34_80e909e3c5834c4a8a1f2adcbfe3a076.pdf
Abstract
Introduction. ANCA - associated vasculitis (AAV) as a term includes: microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA). GPA is characterised by formation of granulomas and inflammation of small and medium-sized vessels leading to organ dysfunction, with a predilection for respiratory tract and kidneys. Gastrointestinal (GI) involvement happens rarely in GPA but when affected, has a poor prognosis.
Case report. We report a case of 50-year-old male with GPA who presents with pulmonary and renal syndrome, along with enterorrhagia due to GI vasculitis. The patient was treated with: hemodialysis, pulse methylprednisolone, cyclophosphamide, and plasmapheresis. Our systematic review of the literature found only a few case reports where gastrointestinal symptoms were one of the first signs of GPA, however, this entity might be more frequent if physicians would think
of this possibility more often. Conclusion. In cases of high clinical suspicion of GI
involvement in GPA, an early aggressive immunosuppressive therapy and eventual surgical intervention remains the cornerstone of the management.
Case report. We report a case of 50-year-old male with GPA who presents with pulmonary and renal syndrome, along with enterorrhagia due to GI vasculitis. The patient was treated with: hemodialysis, pulse methylprednisolone, cyclophosphamide, and plasmapheresis. Our systematic review of the literature found only a few case reports where gastrointestinal symptoms were one of the first signs of GPA, however, this entity might be more frequent if physicians would think
of this possibility more often. Conclusion. In cases of high clinical suspicion of GI
involvement in GPA, an early aggressive immunosuppressive therapy and eventual surgical intervention remains the cornerstone of the management.