Ling Li, Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
Xiao Li, Division of Gastroenterology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
Pak J Med Sci. 2013 Nov;29(6):1465-7. doi: 10.12669/pjms.296.3669.
Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a group of autoimmune diseases that normally affects multiple organs. Recurrent gastrointestinal (GI) bleeding, a critical complication of AAV, remains a challenge. Here, we report a case of AAV complicated by pulmonary hemorrhage, severe recurrent gastrointestinal bleeding, and rapid progressive renal insufficiency that was treated successfully with selective transarterial embolization, continuous veno-venous hemofiltration, plasma exchange, intravenous gamma globulin infusion, followed by steroids and cytotoxic drug therapy. We report this case considering that selective transarterial embolization may be a safe and effective alternative method in recurrent AAV associated GI bleeding caused by AAV refractory to medical therapy.
抗中性粒细胞胞浆抗体相关性血管炎(AAV)是一组自身免疫性疾病,通常影响多个器官。复发性胃肠道(GI)出血是 AAV 的一个严重并发症,仍然是一个挑战。在这里,我们报告了一例 AAV 合并肺出血、严重复发性胃肠道出血和快速进行性肾功能不全的病例,该病例通过选择性动脉栓塞、持续静脉-静脉血液滤过、血浆置换、静脉注射丙种球蛋白输注,随后使用类固醇和细胞毒性药物治疗,成功得到了治疗。我们报告这个病例是因为考虑到选择性动脉栓塞可能是一种安全有效的替代方法,适用于对药物治疗无效的 AAV 相关 GI 出血的复发性 AAV。