Wegener's granulomatosis presenting during pregnancy with acute limb ischemia.
We report a rare case of a pregnant woman with Wegener's granulomatosis whose disease involved the lungs, the spleen, and a limb. Wegener's granulomatosis was clinically manifested in the 34th week of pregnancy with pulmonary infiltrates, splenic infarcts, and acute limb ischemia. Successive thrombectomies failed to maintain arterial flow in the distal limb due to the development of active vasculitis. Thrombosis of the tibial arteries and recurrence of thrombosis was a persistent clinical observation. In the meantime, a cesarean section was performed, with a successful delivery of a healthy male newborn. Because of the recent cesarean section, the patient did not undergo thrombolysis. The woman finally underwent amputation of the limb. According to the reviewed literature, this is the sixth reported case of Wegener's granulomatosis presenting with digital ischemia and the first manifested during pregnancy.
Bessias
Nikolaos
N
Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.
Moulakakis
Konstantinos G
KG
Lioupis
Christos
C
Bakogiannis
Konstantinos
K
Sfyroeras
Giorgos
G
Kakaletri
Konstantina
K
Andrikopoulos
Vassilios
V
D000208:Acute Disease; D000328:Adult; D000671:Amputation, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011859:Radiography