Vasculitis of the gallbladder: case report and spectrum of disease

Area of Science:

• Immunology
• Pathology
• Gastroenterology

Background:

• Polyarteritis nodosa and microscopic polyangiitis are systemic vasculitides affecting small to medium-sized arteries.
• Microscopic polyangiitis is frequently associated with perinuclear antineutrophil cytoplasmic antibodies (p-ANCA), predominantly antimyeloperoxidase (anti-MPO) antibodies.

Observation:

• This report details the first documented case of p-ANCA-associated vasculitis presenting primarily with cholecystitis.
• The vasculitis involved small and medium-sized blood vessels within the gallbladder.

Findings:

• The patient exhibited symptoms consistent with gallbladder inflammation due to vasculitis.
• The condition presented as a localized arteritis of the gallbladder.

Implications:

• This case expands the known clinical spectrum of p-ANCA-associated vasculitis.
• It underscores the importance of considering vasculitis in gallbladder disease, even in the absence of typical systemic symptoms.
• Management strategies range from observation for localized disease to immunosuppression for multiorgan involvement.