title: Intestinal involvement in Wegener's granulomatosis diagnosed and followed up by double balloon enteroscopy.
abstract: Wegener's granulomatosis (WG) is a multisystemic disease of unknown etiology characterized by necrotizing vasculitis and granulomatous inflammation (1-3). The disease typically involves the upper airways, lungs and kidneys, and gastrointestinal involvement is uncommon. Described here is a 33-year-old man who presented at the hospital with abdominal pain. Colonoscopy revealed multiple ulcers, including round ulcers, throughout the large intestine. Small bowel ulcers were detected by double balloon enteroscopy (DBE). Further study confirmed that these ulcers were caused by gastrointestinal complications of WG. The patient was administered prednisolone and cyclophosphamide and remains in remission. This case indicates the importance of considering a gastrointestinal complication of WG as the potential cause of abdominal symptoms among WG patients as well as the use of DBE in detecting such a complication.
authors.affiliation: Department of Gastroenterology, Juntendo University, School of Medicine, Japan. kazukobp@juntendo.ac.jp
authors.forename: Kazuko
authors.initials: K
authors.lastname: Beppu
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Kanako
authors.initials: K
authors.lastname: Inoue
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Naoto
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Masato
authors.initials: M
authors.lastname: Kawabe
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ogihara
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D058582:Double-Balloon Enteroscopy; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome; D014456:Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone