年轻女性因髓过氧化物酶-抗中性粒细胞胞质抗体相关性血管炎而行慢性血液透析时发生肠动脉破裂性动脉瘤。
A Ruptured Jejunal Arterial Aneurysm in a Young Woman Undergoing Chronic Hemodialysis Due to Myeloperoxidase-antineutrophil Cytoplasmic Antibody-associated Vasculitis.
机构信息
Department of Internal Medicine, Teikyo University School of Medicine, Japan.
出版信息
Intern Med. 2021 Sep 15;60(18):2939-2945. doi: 10.2169/internalmedicine.6721-20. Epub 2021 Mar 29.
Abstract
A 21-year-old woman was admitted to our hospital because of massive intestinal bleeding. She started hemodialysis due to myeloperoxidase antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) at 18 years of age. Her ANCA titers remained stable; however, her C-reactive protein increased on 5 mg/day prednisolone before admission. Computed tomography angiography revealed a ruptured jejunal arterial aneurysm. Transcatheter arterial embolization, blood transfusion and the reinforcement of steroid therapy resolved her symptoms of AAV. Our case of a young patient with AAV and medium-sized arterial vasculitis is rare and emphasizes that the ANCA titer does not always rise, especially in patients with nonrenal vasculitis flare-ups.
摘要
一位 21 岁女性因大量肠道出血而入院。她在 18 岁时因髓过氧化物酶抗中性粒细胞胞质抗体（ANCA）相关性血管炎（AAV）开始接受血液透析。她的 ANCA 滴度保持稳定；然而，在入院前，她每天服用 5 毫克泼尼松龙，C 反应蛋白升高。计算机断层血管造影显示空肠动脉破裂性动脉瘤。经导管动脉栓塞、输血和强化激素治疗缓解了她的 AAV 症状。我们的这个年轻 AAV 合并中等大小动脉血管炎的病例比较少见，强调了 ANCA 滴度并不总是升高，尤其是在非肾血管炎发作的患者中。
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