Middle colic artery rupture in a patient with ANCA associated vasculitis: a case report.
Antineutrophil cytoplasmic antibody (ANCA) positive vasculitides are a heterogeneous group of disorders. They can be disabling multi-organ system conditions. Involvement of small and occasionally medium-sized blood vessels is generally the rule. Recent classification changes and advances in laboratory testing have made it easier to work up a patient suspected of having an ANCA-associated vasculitis. Syndromes can at times overlap, leaving a class of patient that does not fit into one specific group. Patients frequently present with a myriad of symptoms ranging from sore throat, fever, athralgias and myalgias, to overt hemorrhage and/or renal failure. The standard treatment remains immunosuppression with steroids, as well as the use of cyclophosphamide, azathioprine, or methotrexate. Plasmapheresis and intravenous immunoglobulin (IVIG) are also used. Gastrointestinal complications are a rare manifestation, first described in polyarteritis nodosa and more recently noted in Wegener's granulomatosis. This paper describes a patient with ANCA positive vasculitis who had a spontaneous rupture of the middle colic artery and multiple superior mesenteric aneurisms. It reviews current literature on the ANCA positive vasculitides, including current classification and treatment modalities.
Dutton-Gaddis
Jonelle G
JG
Oklahoma State University Center for Health Sciences, USA.
Oyekan
Temitayo B
TB
Haraway
G Davin
GD
Crapse
Fred J
FJ
D000783:Aneurysm / Q000150:complications*; D016736:Antiphospholipid Syndrome / Q000150:complications*; D003106:Colon / Q000098:blood supply*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology; D008638:Mesenteric Arteries; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000150:complications; D014657:Vasculitis / Q000150:complications*; D020246:Venous Thrombosis / Q000175:diagnosis