Korean J Nephrol.  2005 Nov;24(6):993-998.

A Case of Microscopic Polyangiitis with Ischemic Colitis

Affiliations
  • 1Department of Internal Medicine, Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea. eylee@sch.ac.kr

Abstract

Microscopic polyangiitis (MPA) is a systemic small vessel vasculitis, which is frequently complicated with rapidly progressive necrotizing glomerulonephritis. Patients with MPA often have demonstrable perinuclear antineutrophil cytoplasm antibodies (p-ANCA) in serum. The most common age of onset is 40 to 60 years and is more common in men. Gastrointestinal (GI) tract involvement is present in about 30-40%. Small bowel involvement is more common and ischemic colitis in the rectum is rare. We have experienced a case of microscopic polyangiitis with ischemic colitis in the rectum, p-ANCA positive and cresent formation on renal biopsy. A 72-year-old woman was admitted with two weeks history of abdominal pain. Total colonoscopy revealed colon obstruction with severe mucosal edema. Urine study showed hematuria and proteinuria. Serum creatinine was elevated progressively. Serume p-ANCA was positive. The titer of p-ANCA was decreased and colon obstruction was recovered after steroid and cyclophosphamide therapy.

Keyword

Microscopic polyangiitis; ANCA; Ischemic colitis

MeSH Terms

Abdominal Pain
Age of Onset
Aged
Antibodies
Antibodies, Antineutrophil Cytoplasmic
Biopsy
Colitis, Ischemic*
Colon
Colonoscopy
Creatinine
Cyclophosphamide
Cytoplasm
Edema
Female
Glomerulonephritis
Hematuria
Humans
Male
Microscopic Polyangiitis*
Proteinuria
Rectum
Vasculitis
Antibodies
Antibodies, Antineutrophil Cytoplasmic
Creatinine
Cyclophosphamide
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