PDF(Pubmed)
Abstract：
BACKGROUND: Granulomatosis with polyangiitis (GPA) is a systematic autoimmune disease. The typical clinical involvement of GPA entails the upper and lower respiratory tracts, and the kidneys. Gastrointestinal (GI) involvement is uncommon and unless detected and treated promptly, may lead to life-threatening complications such as perforation. We aim to review all available publications since the first description in 1982 dealing with GI perforation in patients with Wegener granulomatosis and draw attention to this serious situation.
METHODS: We present a 54-year-old man diagnosed with GPA who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We also review previously reported patients with Wegener granulomatosis who had GI perforation to investigate the perforation site and period, pathology, diagnosis, and treatment methods.
METHODS: The case of a GPA-diagnosed patient who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We recommended a renal puncture biopsy, steroids, and immunosuppressants to improve the patient condition. The patient and his family refused these treatment recommendations.
RESULTS: Our patient exhibited continued progressive vascular inflammatory changes and eventual irreversible systemic damage. These sequelae were attributed to the patient declining prednisolone and immunosuppressant therapy.
CONCLUSIONS: GI perforation is rare in GPA but severe complication. Consequently, we recommend that early diagnosis and treatment with steroid hormones and immunosuppressants for GPA patients with GI perforation.
METHODS: We present a 54-year-old man diagnosed with GPA who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We also review previously reported patients with Wegener granulomatosis who had GI perforation to investigate the perforation site and period, pathology, diagnosis, and treatment methods.
METHODS: The case of a GPA-diagnosed patient who presented initially with nasal symptoms and suffered ileal perforation following Corona Virus Disease 2019 infection. We recommended a renal puncture biopsy, steroids, and immunosuppressants to improve the patient condition. The patient and his family refused these treatment recommendations.
RESULTS: Our patient exhibited continued progressive vascular inflammatory changes and eventual irreversible systemic damage. These sequelae were attributed to the patient declining prednisolone and immunosuppressant therapy.
CONCLUSIONS: GI perforation is rare in GPA but severe complication. Consequently, we recommend that early diagnosis and treatment with steroid hormones and immunosuppressants for GPA patients with GI perforation.
摘要：
背景：肉芽肿性多血管炎（GPA）是一种系统性自身免疫性疾病。GPA的典型临床涉及上呼吸道和下呼吸道，还有肾脏.胃肠道（GI）受累并不常见，除非发现并及时治疗，可能导致危及生命的并发症，如穿孔。我们的目标是回顾自1982年首次描述以来有关韦格纳肉芽肿病患者胃肠道穿孔的所有可用出版物，并引起人们对这种严重情况的关注。
方法：我们介绍了一名被诊断为GPA的54岁男性，最初出现鼻腔症状，并在2019年冠状病毒病感染后出现回肠穿孔。我们还回顾了以前报道的胃肠道穿孔的韦格纳肉芽肿患者，以调查穿孔部位和时期。病理学,诊断,和治疗方法。
方法：一名经GPA诊断的患者，最初出现鼻腔症状，并在2019年冠状病毒病感染后出现回肠穿孔。我们建议做肾穿刺活检,类固醇,和免疫抑制剂来改善病人的状况。患者及其家人拒绝了这些治疗建议。
结果：我们的患者表现出持续的进行性血管炎症改变和最终不可逆的全身损害。这些后遗症归因于患者泼尼松龙和免疫抑制剂治疗的下降。
结论：胃肠道穿孔在GPA中很少见，但并发症严重。因此,我们建议早期诊断并使用类固醇激素和免疫抑制剂治疗有胃肠道穿孔的GPA患者。
方法：我们介绍了一名被诊断为GPA的54岁男性，最初出现鼻腔症状，并在2019年冠状病毒病感染后出现回肠穿孔。我们还回顾了以前报道的胃肠道穿孔的韦格纳肉芽肿患者，以调查穿孔部位和时期。病理学,诊断,和治疗方法。
方法：一名经GPA诊断的患者，最初出现鼻腔症状，并在2019年冠状病毒病感染后出现回肠穿孔。我们建议做肾穿刺活检,类固醇,和免疫抑制剂来改善病人的状况。患者及其家人拒绝了这些治疗建议。
结果：我们的患者表现出持续的进行性血管炎症改变和最终不可逆的全身损害。这些后遗症归因于患者泼尼松龙和免疫抑制剂治疗的下降。
结论：胃肠道穿孔在GPA中很少见，但并发症严重。因此,我们建议早期诊断并使用类固醇激素和免疫抑制剂治疗有胃肠道穿孔的GPA患者。
