Current issue
Archive
Online first
About the Journal
Editorial Office
Editorial Board
Publisher
Editorial Policies
Ethical standards and procedures
Abstracting and indexing
Reviewers
Honorary Reviewers
Subscription
Contact
Most read articles
Instructions for authors
Article processing charge (APC)
Books and Events
Books
Events
CASE REPORT
Coexistence of granulomatosis with polyangiitis (GPA) and Crohn’s disease or multiorgan manifestation of the same disease?
Submission date: 2016-03-14
Final revision date: 2016-04-21
Acceptance date: 2016-05-02
Online publication date: 2016-06-03
Publication date: 2016-04-30
Reumatologia 2016;54(2):86-90
KEYWORDS
TOPICS
ABSTRACT
Granulomatosis with polyangiitis (GPA) is a systemic necrotizing vasculitis of unknown aetiology, often related to the antineutrophil cytoplasmic antibody (ANCA). GPA was previously named Wegener’s granulomatosis (WG). The disease frequently has multisystemic presentation, targeting mainly the respiratory tract and kidneys, but gastrointestinal involvement is uncommon. Crohn’s disease (CD) is an inflammatory bowel disease (IBD) with many extraintestinal manifestations. Clinically, symptoms of WG and CD can mimic each other. In this paper a case of GPA manifested initially by severe multiorgan damage including colitis, regarded to be coexistent CD, is presented. The case illustrates the difficulties in establishing the diagnosis when symptoms of the diseases mimic each other.
REFERENCES (21)
1.
Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65: 1-11.
2.
Madej M, Matuszewska A, Białowąs K, et al. Clinical forms of granulomatosis with polyangiitis. Reumatologia 2014; 52: 332-338.
3.
Hoffman GS, Kerr GS, Leavitt RY, et al. Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 1992; 116: 488-498.
4.
Storesund B, Gran JT, Koldingsnes W. Severe intestinal involvement in Wegener’s granulomatosis: report of two cases and review of the literature. Br J Rheumatol 1998; 37: 387-390.
5.
Hawoth SJ, Pusey CD. Severe intestinal involvement in Wegener’s granulomatosis. Gut 1984; 25: 1296-1300.
6.
Levine JB, Lukawski-Trubish D. Extraintestinal consideration in inflammatory bowel disease. Gastroenterol Clin North Am 1995; 24: 633-646.
7.
Camus P, Piard F, Ashcroft T, et al. The lung in inflammatory bowel disease. Medicine (Baltimore). 1993; 72: 151-183.
8.
Fauci AS, Haynes BF, Katz P, et al. WG: prospective clinical and therapeutic experience 85 patients for 21 years. Ann Intern Med 1983; 98: 76-85.
9.
Casey MB, Tazelaar HD, Myers JL, et al. Noninfectious lung pathology in patients with Crohn’s disease. Am J Surg Pathol 2003; 27: 213-219.
10.
Izzedine H, Lacaille S, Deray G. An unusual presentation of relapsing Wegener’s granulomatosis. Nehrol Dial Transplant 2001; 16: 1511-1512.
11.
Deniz K, Ozseker HS, Balas S, et al. Intestinal involvement in Wegener’s granulomatosis. J Gastrointesin Liver Dis 2007; 16: 329-331.
12.
Sieczkowska A, Landowski P, Szumera M, et al. Coexistance of Crohn disease and Wegener granulomatosis in a 15-year-old patient. Med Wieku Rozwoj 2011; 15: 472-476.
13.
Qian Q, Cornell L, Chandan V, et al. Hemorrhagic colitis as a presenting feature of Wegener granulomatosis. J Gastrointestin Liver Dis 2010; 19: 445-447.
14.
Humbert S, Guilpain P, Puechl X, et al. Inflammatory bowel diseases in anti-neutrophil cytoplasmic antibody-associated vasculitides: 11 retrospective cases from the French Vasculitis Study Group. Rheumatology (Oxford) 2015; 54: 1970-1975.
15.
Kallenberg CG, Brouwer E, Weening JJ, et al. Anti-neutrophil cytoplasmic antibodies: current diagnostic and pathophysiological potential. Kidney Int 1994; 46: 1-15.
16.
Rao JK, Weinberger M, Oddone EZ, et al. The role of antineutrophil cytoplasmic antibody (c-ANCA) testing in the diagnosis of Wegener’s granulomatosis. Ann Intern Med 1995; 113: 925-932.
17.
Csernok E, Trabandt A, Muller A, et al. Cytokine profiles in Wegener’s granulomatosis: predominance of type 1(Th1) in the granulomatous inflammation. Arthritis Rheum 1999; 42: 742-750.
18.
Fuss IJ, Becker C, Yang Z, et al. Both IL -12p70 and IL-23 are synthesized during active Crohn’s disease and are down-regulated by treatment with ani-IL-12 p40 monoclonal antibody. Inflam Bowel Dis 2006; 12: 9-15.
19.
Desplat-Jégo S, Johanet C, Escande A, et al. Update on anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: results of a multicenter study. World J Gastroenterol 2007; 13: 2312-2318.
20.
Sokol RJ, Farrell MK, McAdams AJ. An unusual presentation of Wegener’s granulomatosis mimicking inflammatory bowel disease. Gastroenterology 1984; 87: 426-432.
21.
Madej M, Matuszewska A, Białowąs K, et al. Ziarniniakowatość z zapaleniem naczyń – problemy diagnostyczne. Reumatologia 2014; 52: 344-346.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Share
RELATED ARTICLE
| eISSN: | 2084-9834 |
| ISSN: | 0034-6233 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
