title: [Acute abdomen in a patient with ANCA-associated vasculitis].
abstract: METHODS
  A 49-year-old man complained of increasing pain in the lower left abdomen. Three weeks previously joint pain had developed, and in the last 7 days the patient had noted a cutaneous rash at the lower legs. Within three days after admission a paralytic ileus developed, progressed and culminated in a small bowel perforation. In the 60 cm ileum specimen as well as in the skin lesions there was marked intra- und perivascular infiltration with neutrophil granulocytes and focal necrosis, but no granuloma.
  
  
  METHODS
  As the proteinase 3 subtype of antineutrophil cytoplasmic antibodies (ANCA) was positive ANCA-associated vasculitis with gastrointestinal, cutaneous and kidney involvement was diagnosed. After initiation of cytostatic treatment with methylprednisolone boli und cyclophosphamide the patient's condition improved. The post-operative course was uneventful.
  
  
  CONCLUSIONS
  ANCA-associated vasculitis rarely presents with severe gastrointestinal complications. The disease represents an interdisciplinary challenge because of its variable clinical presentation and the possibly lethal outcome if not adequately treated.
authors: Universitätsklinik für Gastroenterologie, Hepatologie und Infektiologie der Otto-von-Guericke Universität Magdeburg.
authors: M
authors: M
authors: Varbanova
authors: K
authors: K
authors: Schütte
authors: D
authors: D
authors: Kuester
authors: M
authors: M
authors: Bellutti
authors: I
authors: I
authors: Franke
authors: J
authors: J
authors: Steinbach
authors: H
authors: H
authors: Scheidbach
authors: P
authors: P
authors: Malfertheiner
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology* / Q000601:surgery; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007081:Ileostomy; D007082:Ileum / Q000473:pathology / Q000601:surgery; D007416:Intestinal Perforation / Q000175:diagnosis / Q000473:pathology; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D014057:Tomography, X-Ray Computed