1. A rare case of Goodpasture syndrome concomitant with bleeding jejunal Dieulafoy’s lesion
- Author
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Yuki Ueda, Tsutomu Shikano, Yuji Okazaki, Shigehiro Motoi, Naonori Inoue, Katsutoshi Yamaguchi, Masayasu Nishimura, Masatoshi Miyata, Hideaki Kawabata, Misuzu Hitomi, Daiki Sone, and Yukino Kawakatsu
- Subjects
Male ,Enteroscopy ,medicine.medical_specialty ,Anti-Glomerular Basement Membrane Disease ,medicine.medical_treatment ,Gastroenterology ,Endoscopy, Gastrointestinal ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Goodpasture syndrome ,Aged, 80 and over ,Hemostatic Techniques ,business.industry ,Glomerulonephritis ,Jejunal Diseases ,General Medicine ,Dieulafoy's lesion ,medicine.disease ,030220 oncology & carcinogenesis ,Hemostasis ,030211 gastroenterology & hepatology ,Plasmapheresis ,Pulmonary hemorrhage ,medicine.symptom ,Gastrointestinal Hemorrhage ,Tomography, X-Ray Computed ,business - Abstract
An 81-year-old man was diagnosed with Goodpasture syndrome (GS) because he met the criteria of positive anti-GBM antibodies, rapid progressive glomerulonephritis and pulmonary hemorrhage. After starting plasmapheresis and steroid pulse therapy, he experienced tarry stool and contrast-enhanced CT revealed an aneurysmal finding in the jejunum. Paroral enteroscopy showed a jejunal Dieulafoy's lesion (DL) with gush-out hemorrhage. Hemostasis was successfully achieved by hemoclipping, and he then experienced no re-bleeding events. GS can present as a jejunal DL, and contrast-enhanced CT is useful for investigating the etiology and site of small intestinal bleeding, which can lead to smooth, effective endoscopic hemostasis.
- Published
- 2019
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