title: Gastrointestinal involvement at the onset of granulomatosis with polyangiitis: A case report.
abstract: A 30-year-old man had developed fever, bloody stools, and oral aphtha. Proteinase 3-antineutrophil cytoplasmic antibody level was 31 EU. Lower intestinal endoscopy revealed edematous mucosa with hemorrhage in the transverse colon. Biopsies of oral aphtha showed necrotizing angiitis with granuloma. Based on these findings, he was diagnosed with granulomatosis with polyangiitis (GPA). Digestive symptoms were remitted by treatment with prednisolone and azathioprine. GPA with digestive symptoms as the initial development is rare.
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Yoshikawa
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Fujiki
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.affiliation: a Department of Internal Medicine (I) , Osaka Medical College , Takatsuki City, Osaka , Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D005938:Glucocorticoids / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D013281:Stomatitis, Aphthous / Q000209:etiology*
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine
keywords: Azathioprine; Granulomatosis with polyangiitis; Oral intestinal symptoms; PR3-ANCA; Primary manifestation