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Granulomatosis with polyangiitis presenting as pancreatic disease
- Source :
- BMJ Case Rep
- Publication Year :
- 2023
-
Abstract
- Granulomatosis with polyangiitis (GPA) is a rare necrotising small vessel vasculitis typically associated with oronasal, pulmonary and renal manifestations. Pancreatic disease is an exceedingly rare initial presentation and is associated with delayed diagnosis and rapid progression. We discuss a 66-year-old woman presenting with epigastric pain, elevated lipase and radiographic evidence of focal pancreatitis. She had no relevant medical history and no lithiasis seen on imaging. Pertinent findings include strawberry gingivitis, positive proteinase-antineutrophil cytoplasm antibody (98% specificity) and focal nodular parenchymal lung lesions on CT chest—all of which are consistent with a diagnosis of GPA. She was promptly started on high-dose steroids which resulted in significant clinical and biochemical improvement. Cyclophosphamide was added once biopsy confirmed the absence of malignancy. In order to optimise the clinical outcomes of GPA, physicians must keep a wide differential and high index of suspicion in the setting of unexplained pancreatitis with systemic features.
- Subjects :
- medicine.medical_specialty
Pancreatic disease
Biopsy
Case Report
Malignancy
Gastroenterology
Antibodies, Antineutrophil Cytoplasmic
03 medical and health sciences
0302 clinical medicine
Internal medicine
Medicine
Humans
Medical history
Cyclophosphamide
Aged
030203 arthritis & rheumatology
Lung
medicine.diagnostic_test
business.industry
Granulomatosis with Polyangiitis
Pancreatic Diseases
General Medicine
medicine.disease
medicine.anatomical_structure
Pancreatitis
030211 gastroenterology & hepatology
Female
business
Vasculitis
Granulomatosis with polyangiitis
Subjects
Details
- ISSN :
- 1757790X
- Volume :
- 14
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- BMJ case reports
- Accession number :
- edsair.doi.dedup.....ce5187538a79cfcfc61871c05dde7bd3