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Rheumatology (Oxford). 2010 Jul;49(7):1326-35. doi: 10.1093/rheumatology/keq093. Epub 2010 Apr 1.

Localized vasculitis of the gastrointestinal tract: a case series.

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  • 1Unità di Reumatologia, Arcispedale S Maria Nuova, Reggio Emilia, Italy.

Abstract

OBJECTIVE:

To describe the clinical features and outcomes of patients with localized vasculitis of the gastrointestinal tract (LVGT).

METHODS:

Medical records of 608 patients diagnosed with vasculitis involving the intra-abdominal vasculature and/or abdominal viscera between January 1996 and December 2007 were reviewed. Only patients with histopathological confirmation or typical angiographic findings of vasculitis localized to the abdomen were included.

RESULTS:

We identified 18 cases with LVGT over the 12-year study period. The patients were predominantly Caucasian (89%) and female (67%) with a median age at diagnosis of 53.5 (range 17.4-83.3) years. Most of the patients presented with abdominal pain and 12 (66.6%) patients presented with an acute abdomen requiring surgical intervention. At diagnosis, the median ESR was 30.5 (range 4-77) mm/h. Autoantibody screening was generally unrevealing. Abdominal CT scan findings included: bowel wall thickening, bowel infarction and solid organ infarcts. In 14 patients, the diagnosis of vasculitis was established by abdominal angiography. Histological evidence of vasculitis was recorded in 5 (28%) patients, most commonly from gall bladder or small intestine specimens. Corticosteroid therapy was administered to 10 (56%) patients, 5 of whom also received other immunosuppressive agents. Median duration of follow-up was 10.5 (range 2-156) months. No evidence of vasculitis outside the abdomen was observed during follow-up. Seven (39%) patients died during the follow-up period. Survival of the patient cohort (compared with an age-matched US white population) was significantly reduced (P < 0.001).

CONCLUSION:

LVGT is an uncommon form of vasculitis that can be associated with significant morbidity and mortality.

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