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Vasculitis as a cause of diarrhea and gastrointestinal hemorrhage: a case report
E Kotiloğlu1, M Cağlar, C Akyüz
1Department of Pediatrics-Section of Pediatric Pathology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
Insights
A rare case of polyarteritis nodosa caused fatal gastrointestinal bleeding in a 13-year-old girl. Autopsy confirmed systemic vasculitis affecting the lungs, GI tract, and kidneys.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Pathology
Background:
- Polyarteritis nodosa (PAN) is a systemic vasculitis affecting medium-sized arteries.
- PAN can present with diverse symptoms, often involving multiple organ systems.
- Gastrointestinal involvement in PAN can lead to severe complications.
Observation:
- A 13-year-old female presented with fever, malaise, intractable diarrhea, and gastrointestinal hemorrhage.
- Despite intensive medical management, the patient experienced massive upper gastrointestinal bleeding.
- The patient ultimately succumbed to the severe hemorrhage.
Findings:
- Autopsy revealed systemic polyarteritis nodosa (PAN) of classic form in the right lung and gastrointestinal tract.
- Microscopic form of PAN was identified in the kidneys.
- The vasculitis was determined to be the cause of the fatal gastrointestinal bleeding.
Implications:
- This case highlights the potential for severe, life-threatening gastrointestinal hemorrhage in pediatric PAN.
- Early recognition and diagnosis of PAN are crucial for timely intervention.
- Understanding the diverse manifestations of PAN is essential for effective patient management.
Abstract:
A 13-year-old girl was hospitalized for fever, malaise, intractable diarrhea, and intermittent gastrointestinal hemorrhage. Despite aggressive antimicrobial and supportive treatment, she died with massive bleeding from the upper gastrointestinal tract. Autopsy study revealed systemic polyarteritis nodosa of classic form in the right lung and gastrointestinal tract and of microscopic form in kidneys.