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Recurrent gastrointestinal bleeding due to jejunal artery vasculitis as debut presentation of granulomatosis with polyangiitis
  1. Saddam Yasin1 and
  2. Kanwal Mehmood2
  1. 1Department of Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
  2. 2Department of Internal Medicine, Shalamar Medical and Dental College, Lahore, Pakistan
  1. Correspondence to Dr Saddam Yasin; saddamyasinmd{at}gmail.com

Abstract

Granulomatosis with polyangiitis (GPA) is characterised by systemic necrotising vasculitis of small arteries and veins with multitude of organ involvement, with the most common being the upper and lower respiratory tract and renal system. Gastrointestinal involvement is a rare late manifestation with a high mortality rate and usually results in intestinal perforation. Our patient presented with gastrointestinal bleeding secondary to jejunal artery vasculitis. Gastrointestinal bleeding as initial presentation of GPA is very rarely documented. CT mesenteric angiogram is helpful for the localisation of bleed in these cases. In case of refractory bleeding, surgical excision is required.

  • GI bleeding
  • vasculitis

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Footnotes

  • Contributors All the authors, namely SY and KM, have contributed to the preparation of this manuscript. SY was involved in the direct care of the patient and identifying the uniqueness of the case while KM has helped in writing the discussion part of the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.