Localized vasculitis of the gastrointestinal tract.
OBJECTIVE
Isolated vasculitis of the gastrointestinal (GI) tract is a rare entity. Endoscopic biopsies have low sensitivity to diagnose intestinal vasculitis, even though the endoscopic findings may be suggestive of this condition. Our aims were to describe a case of biopsy-proven colonic leukocytoclastic vasculitis and review the literature.


METHODS
A patient with biopsy-proven colonic leukocytoclastic vasculitis is described. A Medline database search of cases with localized GI vasculitis between January 1985 and September 2005 was conducted.


RESULTS
A 32-year-old man was admitted to the hospital because of abdominal pain and diarrhea. A colonic biopsy showed leukocytoclastic vasculitis. There are very few articles on leukocytoclastic GI vasculitis as a separate disease, and most of them emphasize the difficulty in classification. Unlike our case, in former cases of localized vasculitis a diagnosis was made after surgery. Although our patient had steroid-refractory biopsy-proven isolated intestinal vasculitis, treatment with intravenous cyclophosphamide resulted in rapid resolution of symptoms and surgery was not required.


CONCLUSIONS
In patients with abdominal pain a diagnosis of intestinal vasculitis should be considered. Immunosuppressive therapy allowed our patient to avoid surgery and may be similarly beneficial in other similar cases.
Garcia-Porrua
Carlos
C
Rheumatology Division, Hospital Xeral-Calde, 27004 Lugo, Spain. cgporrua@hotmail.com
Gutierrez-Duque
Olga
O
Soto
Santiago
S
Garcia-Rodeja
Eugenia
E
Gonzalez-Gay
Miguel A
MA
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D001706:Biopsy; D003113:Colonoscopy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D012810:Sigmoid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone; D008775:Methylprednisolone