Patient with mesenteric ischemia and granulomatosis with polyangiitis, a rare association: Case report
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Abstract
Granulomatosis with polyangiitis (GPA) is a small vessel vasculitis, it is associated with antineutrophil cytoplasmic antibodies (ANCA), it mainly involves the upper respiratory tract and gastrointestinal involvement is present in 4-20%. However, mesenteric ischemia is one of the more unusual associations. A case is reported of a 64-year-old man with chronic rhino-sinus symptoms, who consulted for abdominal pain associated with palpable purpuric lesions; later, with symptoms of acute abdomen that required emergency exploratory laparotomy where mesenteric ischemia was evident. The differential of systemic thromboembolic causes was performed, common causes were ruled out and during the diagnostic exercise, a positive ANCA proteinase 3 (PR3) GPA was documented, through clinical, paraclinical and histopathological criteria. Treatment with cyclophosphamide and corticosteroids was initiated, there was significant improvement of the initial clinical manifestations.
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