Korean J Med.
2012 Jul;83(1):127-131.
A Case of Hemocholecystitis in a Patient with Microscopic Polyangiitis
- Affiliations
-
- 1Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Seoul, Korea. everlover7@hallym.or.kr
- 2Department of Pathology, Hallym University Sacred Heart Hospital, Anyang, Seoul, Korea.
Abstract
- Microscopic polyangiitis (MPA) is a systemic necrotizing vasculitis, primarily associated with rapidly progressive glomerulonephritis and alveolar hemorrhage. Approximately 50% of MPA cases are associated with gastrointestinal involvement, but rarely do cases involve the gall bladder. We report an unusual case of MPA complicated by hemocholecystitis. A 62-year-old woman was admitted to our hospital with rapidly progressive renal dysfunction and pneumonia unresponsive to antibiotics. A chest CT scan showed bilateral diffuse alveolar consolidation, and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) staining was positive. During the course of hospitalization, the patient complained of severe abdominal pain, and an abdominal CT scan revealed acalculous cholecystitis with hemorrhage. Cholecystectomy was performed, and a gall bladder biopsy revealed fibrinoid necrosis of small arteries without granuloma. Cholecystitis should be considered in patients with unexplained upper abdominal pain and MPA.
MeSH Terms
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Abdominal Pain
Acalculous Cholecystitis
Anti-Bacterial Agents
Antibodies, Antineutrophil Cytoplasmic
Arteries
Biopsy
Cholecystectomy
Cholecystitis
Female
Glomerulonephritis
Granuloma
Hemorrhage
Hospitalization
Humans
Microscopic Polyangiitis
Middle Aged
Necrosis
Pneumonia
Thorax
Urinary Bladder
Vasculitis
Anti-Bacterial Agents
Antibodies, Antineutrophil Cytoplasmic
