Hajihashemi Ali, Tavallaeinejad Pardis, Geravandi Mahsa
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Med Case Rep. 2025 Mar 3;19(1):89. doi: 10.1186/s13256-025-05108-2.
Vasculitis encompasses a group of disorders characterized by inflammation of blood vessel walls, leading to diverse clinical presentations on the basis of the size and location of the affected vessels. Gastrointestinal involvement is a known feature of small- and medium-sized vessel vasculitides, typically as part of systemic inflammation. However, isolated vasculitis of the celiac artery is extremely rare and has been scarcely reported in the literature, making this case particularly novel and significant.
We report the case of a 35-year-old Iranian male of Persian ethnicity who presented with a 7-day history of abdominal pain localized to the epigastric and periumbilical regions, accompanied by nausea. On admission, the patient's vital signs were stable, and clinical examination was unremarkable. Laboratory findings revealed elevated C-reactive protein and erythrocyte sedimentation rate. Contrast-enhanced abdominopelvic computed tomography suggested isolated vasculitis of the celiac artery. Subsequent serological tests showed borderline positive anti-nuclear antibodies, while other specific autoantibodies were negative. On the basis of clinical and radiological findings, the patient was diagnosed with isolated celiac artery vasculitis. Treatment with oral corticosteroids for 10 days led to symptom resolution and normalization of C-reactive protein levels. A follow-up computed tomography scan performed 2 weeks after treatment completion demonstrated complete resolution of inflammatory changes with no residual abnormalities. At 6-month follow-up, the patient remained asymptomatic, with no recurrence of symptoms or complications.
Isolated celiac artery vasculitis is an extremely rare condition that requires high clinical suspicion for timely diagnosis. Early intervention can effectively prevent life-threatening complications and reduce morbidity. This case highlights the importance of recognizing isolated vascular inflammation as a potential diagnosis in patients presenting with unexplained abdominal pain and elevated inflammatory markers.
血管炎是一组以血管壁炎症为特征的疾病，根据受累血管的大小和位置导致多种临床表现。胃肠道受累是中小血管血管炎的已知特征，通常是全身炎症的一部分。然而，腹腔动脉孤立性血管炎极为罕见，文献中鲜有报道，因此该病例尤为新颖且具有重要意义。
我们报告了一名35岁的伊朗波斯族男性患者，他有7天的上腹部和脐周腹痛病史，并伴有恶心。入院时，患者生命体征稳定，临床检查无异常。实验室检查结果显示C反应蛋白和红细胞沉降率升高。腹部盆腔增强计算机断层扫描提示腹腔动脉孤立性血管炎。随后的血清学检查显示抗核抗体临界阳性，而其他特异性自身抗体为阴性。根据临床和影像学检查结果，该患者被诊断为腹腔动脉孤立性血管炎。口服皮质类固醇治疗10天导致症状缓解，C反应蛋白水平恢复正常。治疗完成2周后进行的随访计算机断层扫描显示炎症改变完全消退，无残留异常。在6个月的随访中，患者无症状，症状或并发症未复发。
腹腔动脉孤立性血管炎是一种极为罕见的疾病，需要高度的临床怀疑才能及时诊断。早期干预可有效预防危及生命的并发症并降低发病率。该病例强调了在出现不明原因腹痛和炎症标志物升高的患者中，将孤立性血管炎症作为潜在诊断的重要性。
