Shao Huijuan, Liu Dong, Zheng Xiaofeng, Zhang Jiucong, Li Wenbo, Chen Peng, Qian Zhen, Yang Jie, Liu Dongmei
Department of Gastroenterology, The 940 Hospital of Joint Logistic Support Force of PLA, Lanzhou, China.
Department of Intensive Care Unit, The 940 Hospital of Joint Logistic Support Force of PLA, Lanzhou, China.
Medicine (Baltimore). 2024 Jan 26;103(4):e36973. doi: 10.1097/MD.0000000000036973.
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.
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.
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.
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.
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.
肉芽肿性多血管炎（GPA）是一种系统性自身免疫性疾病。GPA的典型临床受累部位包括上、下呼吸道及肾脏。胃肠道（GI）受累并不常见，除非及时发现并治疗，否则可能导致诸如穿孔等危及生命的并发症。我们旨在回顾自1982年首次描述以来所有关于韦格纳肉芽肿病患者胃肠道穿孔的可用出版物，并提请关注这一严重情况。
我们报告一名54岁男性，被诊断为GPA，最初表现为鼻部症状，在感染2019冠状病毒病后发生回肠穿孔。我们还回顾了先前报道的患有韦格纳肉芽肿病且发生胃肠道穿孔的患者，以调查穿孔部位和时期、病理、诊断及治疗方法。
一名被诊断为GPA的患者，最初表现为鼻部症状，在感染2019冠状病毒病后发生回肠穿孔。我们建议进行肾穿刺活检、使用类固醇和免疫抑制剂以改善患者状况。患者及其家属拒绝了这些治疗建议。
我们的患者表现出持续进展的血管炎性改变以及最终不可逆转的全身损害。这些后遗症归因于患者拒绝泼尼松龙和免疫抑制剂治疗。
胃肠道穿孔在GPA中罕见但为严重并发症。因此，我们建议对患有胃肠道穿孔的GPA患者早期使用类固醇激素和免疫抑制剂进行诊断和治疗。
