Arterial aneurysms in Wegener's granulomatosis: case report and literature review

Semin Arthritis Rheum. 2008 Feb;37(4):265-8. doi: 10.1016/j.semarthrit.2007.07.004. Epub 2007 Sep 21.

Abstract

Objective: Arterial aneurysms are characteristic of medium-size vessel vasculitis but are a very unusual feature of Wegener's granulomatosis (WG). We describe a typical WG case, complicated by arterial aneurysms and review previously reported cases.

Methods: Medline database search of cases published between January 1978 and July 2006, in English, reporting arterial aneurysms complicating WG.

Results: Five years after diagnosis, a 29-year-old man with typical WG developed macro- and microaneurysms located on branches of the hepatic and renal arteries during a disease relapse. The main symptoms were abdominal pain, vomiting, and altered general status. He was successfully treated by coil embolization in combination with prednisone, intravenous mycophenolate mofetil, and high-dose immunoglobulins. Twelve additional cases of WG complicated by arterial aneurysms are reported in the English literature. This represents a life-threatening complication since rupture occurred in half of the patients.

Conclusions: Although small-vessel injury predominates in WG, inflammation of medium-size arteries may occur and lead to aneurysm formation. Abdominal angiography should be recommended when unexplained abdominal pain occurs during a WG flare.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aortic Aneurysm, Abdominal / etiology*
  • Granulomatosis with Polyangiitis / complications*
  • Hepatic Artery*
  • Humans
  • Male
  • Renal Artery*