Brief reportArterial Aneurysms in Wegener’s Granulomatosis: Case Report and Literature Review
Section snippets
Methods
A literature survey from January 1978 to July 2006 was performed using a MEDLINE (PubMed), searching for cases with coexisting WG and aneurysm. Only cases published in English with sufficient clinical data for analysis were reviewed.
Case Report
An Algerian man, born in 1973, was admitted to our department of internal medicine in January 2003, because of weight loss, vomiting, and epigastric pain. He had been diagnosed with WG in May 1997 on the basis of nasal ulcerations with epistaxis, nasal perforation and saddle-nose deformity, sinusitis, orchitis, polyarthralgias, myalgias, subcutaneous nodules, polyneuropathy, and acute renal insufficiency related to pauci-immune crescentic glomerulonephritis. Histological examination of skeletal
Discussion
We report an unusual and severe case of WG with multiple aneurysms located on medium-sized arteries. The diagnosis of WG was based on typical characteristics: rhinitis and sinusitis, pauci-immune crescentic glomerulonephritis, intraalveolar hemorrhage, and polyneuropathy. Histological studies showed giant-cell granuloma and/or necrotizing granulomatous inflammation of medium and small vessels in the skin, muscle, and gastrointestinal tract. Anti-PR3 antibodies were present.
Aneurysms are an
Acknowledgment
We thank Jacques Pouchot, MD, for critically reviewing the manuscript.
References (14)
- et al.
Large vessel aneurysms in Wegener’s granulomatosis
J Vasc Surg
(2002) - et al.
Unusual renal manifestations of Wegener’s granulomatosisReport of two cases
Am J Med
(1978) - et al.
Rupture of a hepatic artery aneurysm caused by Wegener’s granulomatosis
Pathol Res Pract
(1997) - et al.
Small-vessel vasculitis
N Engl J Med
(1997) - et al.
Wegener’s granulomatosis complicated by arterial aneurysm
Intern Med
(1995) - et al.
Pulmonary capillaritis and glomerulonephritis in an antineutrophil cytoplasmic antibody-positive patient with prior granulomatous aortitis
Arch Pathol Lab Med
(1990) - et al.
Periaortitis and aortic dissection due to Wegener’s granulomatosis
Clin Rheumatol
(2000)
Cited by (31)
Management of celiac trunk and superior mesenteric artery synchronous aneurysms as an extremely rare manifestation of Wegener granulomatosis
2019, Journal of Vascular Surgery Cases and Innovative TechniquesContrast-enhanced ultrasound and computed tomography findings of granulomatosis with polyangiitis presenting with multiple intrarenal microaneurysms: A case report
2017, Clinical ImagingCitation Excerpt :GPA that involves the kidneys presents as glomerulonephritis of varying severity, ranging from asymptomatic or mild renal disease to fulminant glomerulonephritis and end-stage renal failure. Intrarenal microaneurysms are an uncommon manifestation of GPA, and only a few cases have been reported [4,5,6,7,8]. A contrast-enhanced CT scan may be normal in a patient with renal GPA.
Multiple visceral artery aneurysms: An uncommon manifestation of antineutrophil cytoplasmic antibody vasculitis
2016, Annals of Vascular SurgeryCitation Excerpt :In the opposite case, revascularization is necessary, with bypass (prosthetic or autologous) or arterial reimplantation.1,2 Endovascular treatment by embolization with coils, glue, thrombin, or covered stents is an alternative to conventional surgery, in particular, among high-risk patients.3,7 The main advantages of endovascular treatment are to avoid a general anesthesia, reduce the morbidity associated with open surgery, and shorten the hospital stay.
Retroperitoneal fibrosis with periaortitis: A case report of an unusual form of presentation of granulomatosis with polyangiitis
2016, Respiratory Medicine Case ReportsGranulomatosis with polyangiitis and intravenous immunoglobulins: A case series and review of the literature
2015, Autoimmunity ReviewsCitation Excerpt :Other than this sole RCT, 4 studies have been ad hoc conducted to assess the efficacy of IVIG in GPA (Table 2) [13–16] reporting clinical benefits and good tolerance in the majority of these patients. Furthermore, 18 anecdotal reports have showed the efficacy of IVIG in a heterogenous population affected by GPA (Table 3) [30–48], while 3 reports did not point out any beneficial effect [49–51]. Kamali et al. [49] described the case of a young patient affected by GPA with intra-alveolar haemorrhage who developed end-stage renal disease requiring haemodialysis, despite CS, CYC and IVIG therapy.
Aortitis with aneurysm formation as a rare complication of Wegener's granulomatosis
2011, Journal of Vascular SurgeryCitation Excerpt :WG in medium-sized vessels is more common and show complicated outcome.4,5 Rupture occurred in half of the patients leading to death from abdominal bleeding in three cases.4,5 Aortic aneurysm as a result of WG is a very rare complication.
The authors have no conflicts of interest to disclose.