Youssef Michael, Sedarous Mary, Grin Andrea, Chung Andrew, Hookey Lawrence
Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Gastroenterology, Kingston Health Sciences Centre, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
ACG Case Rep J. 2023 Feb 10;10(2):e00986. doi: 10.14309/crj.0000000000000986. eCollection 2023 Feb.
Granulomatosis with polyangiitis (GPA) is a rare necrotizing antineutrophil cytoplasmic antibody-associated vasculitis characterized by inflammation in small-sized arteries. Gastrointestinal involvement is exceedingly rare in GPA. Here, we present a case of recurrent acute pancreatitis as the initial presentation of GPA. The diagnosis was made based on radiological and pathological findings of acute pancreatitis in conjunction with positive anti-PR3 antibody which is strongly associated with GPA. Systemic vasculitides are rare but important to consider in cases of idiopathic acute pancreatitis. Early diagnosis and therapy allow for high rates of remission and improved survival rates.
肉芽肿性多血管炎(GPA)是一种罕见的坏死性抗中性粒细胞胞浆抗体相关性血管炎,其特征为小动脉炎症。GPA累及胃肠道极为罕见。在此,我们报告一例以复发性急性胰腺炎为首发表现的GPA病例。诊断基于急性胰腺炎的影像学和病理结果,以及与GPA密切相关的抗蛋白酶3(PR3)抗体阳性。系统性血管炎虽罕见,但在特发性急性胰腺炎病例中需予以考虑。早期诊断和治疗可实现较高的缓解率并提高生存率。