title: Gastrointestinal tract involvement in granulomatosis with polyangiitis.
abstract: BACKGROUND
  Granulomatosis with polyangiitis (GPA) is a necrotising vasculitis of small arteries and veins. In its classical manifestation GPA affects the upper and lower respiratory tract and kidneys. However, other organs, including those of the gastrointestinal tract, may be affected as well.
  
  
  OBJECTIVE
  To present the clinical manifestations of gastrointestinal tract involvement in patients with GPA.
  
  
  METHODS
  We analysed case records of 34 patients with GPA treated in the Department of Nephrology, Transplantology, and Internal Medicine of the Medical University of Gdansk from 1991 to 2009.
  
  
  RESULTS
  In 9 of 34 patients, 2 men and 7 women, aged 18 to 74 years, gastrointestinal complications were observed in the course of GPA. In two of them a localised and in seven a generalised type of GPA was diagnosed. The main symptoms relating to gastrointestinal tract were: oral mucosa ulcerations, gum mucosa hypertrophy, dyspepsia, vomiting, stomachache, gastrointestinal haemorrhage, diarrhoea, and symptoms of gastrointestinal tract perforation. Two patients required urgent surgical treatment. In 2 of the 5 patients who developed gastrointestinal bleeding, it was the direct cause of death. The histopathological confirmation of specificity of changes in gastrointestinal tract was established only in 2 cases. Tissue samples collected during endoscopy usually revealed only nonspecific inflammation or the presence of ulcers.
  
  
  CONCLUSIONS
  Therapeutic strategies accepted for GPA treatment are effective in treating patients with gastrointestinal involvement in the course of the disease. Some complications require surgical intervention.
authors.affiliation: Department and Clinic of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Masiak
authors.affiliation: Department and Clinic of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Zdrojewski
authors.affiliation: Department and Clinic of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Zdrojewski
authors.affiliation: Department and Clinic of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bułło-Piontecka
authors.affiliation: Department and Clinic of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Bolesław
authors.initials: B
authors.lastname: Rutkowski
keywords: gastrointestinal tract bleeding; granulomatosis with polyangiitis