Jari Mohsen, Asgari Marnani Hootan, Chatraei Narges
Department of Pediatric Rheumatology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Iran.
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Iran.
SAGE Open Med Case Rep. 2025 Sep 18;13:2050313X251371985. doi: 10.1177/2050313X251371985. eCollection 2025.
Granulomatosis with polyangiitis is a rare autoimmune disorder. Granulomatosis with polyangiitis's signs and symptoms reflect affected organs, which are inclined toward the respiratory tract and kidneys. Gastrointestinal involvement is uncommon and barely represents this disease, particularly as an initial presentation. Here, we describe a diagnostically challenging case of a 14-year-old boy whose first manifestation of granulomatosis with polyangiitis was gastrointestinal bleeding, initially resembling immunoglobulin A vasculitis. Despite overlapping features such as arthralgia and skin lesions, renal biopsy, and cytoplasmic antineutrophil cytoplasmic antibodies positivity distinctly established granulomatosis with polyangiitis diagnosis. Recognizing gastrointestinal manifestations as potential indicators of granulomatosis with polyangiitis, even when hallmark respiratory symptoms are absent, enhances vigilance, and is crucial for early diagnosis and appropriate management.
肉芽肿性多血管炎是一种罕见的自身免疫性疾病。肉芽肿性多血管炎的体征和症状反映了受影响的器官，这些器官倾向于呼吸道和肾脏。胃肠道受累并不常见，很少代表这种疾病，尤其是作为初始表现时。在此，我们描述了一例具有诊断挑战性的病例，一名14岁男孩，其肉芽肿性多血管炎的首发表现为胃肠道出血，最初类似于免疫球蛋白A血管炎。尽管存在关节痛和皮肤病变等重叠特征，但肾活检和抗中性粒细胞胞浆抗体阳性明确确立了肉芽肿性多血管炎的诊断。认识到胃肠道表现是肉芽肿性多血管炎的潜在指标，即使没有典型的呼吸道症状，也能提高警惕，对早期诊断和适当治疗至关重要。
