Gastrointestinal manifestations of systematic vasculitis

Michael Camilleri, C. D. Pusey, V. S. Chadwick, A. J. Rees

Research output: Chapter in Book/Report/Conference proceedingChapter

107 Citations (Scopus)

Abstract

Systemic vasculitis is known to affect the gastrointestinal tract but the nature of the complication is poorly characterized. Out of 65 patients with systemic vasculitis, the majority of whom had renal disease, the intestine was found to be affected in 18. These comprised four of eight patients with polyarteritis nodosa, nine of seventeen with microscopic polyarteritis, four of thirty-six with Wegener's granulomatosis and one of four with Churg-Strauss syndrome. The features included abdominal pain (85 per cent), diarrhoea (50 per cent), gut haemorrhage (44 per cent) and abnormal liver function tests (50 per cent). Manifestations of gastrointestinal disease were evident at presentation in half the patients and led to a fatal outcome in five. Ileus, mucosal abnormalities, perforation and slow transit were evident radiographically, and selective visceral angiography showed aneurysms or organ infarcts in five patients. Histological assessment of gut biopsies (chiefly rectal) revealed non-specific inflammation of ulceration in nine patients and intramucosal haemorrhage in two. Focal areas of necrosis and ulceration in colonoscopic biopsies were highly suggestive of vasculitis whereas arteritis was only found in one full thickness biopsy. Hence the diagnosis of gastrointestinal complications depends largely on clinical evidence. In patients who survived, the gastrointestinal features remitted as the systemic illness improved following treatment with steroids, cyclophosphamide or plasma exchange.

Original languageEnglish (US)
Title of host publicationQuarterly Journal of Medicine
Pages141-149
Number of pages9
Volume52
Edition206
StatePublished - 1983
Externally publishedYes

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Vasculitis
Systemic Vasculitis
Biopsy
Hemorrhage
Churg-Strauss Syndrome
Polyarteritis Nodosa
Arteritis
Granulomatosis with Polyangiitis
Plasma Exchange
Fatal Outcome
Ileus
Gastrointestinal Diseases
Liver Function Tests
Cyclophosphamide
Abdominal Pain
Intestines
Aneurysm
Gastrointestinal Tract
Diarrhea
Angiography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Camilleri, M., Pusey, C. D., Chadwick, V. S., & Rees, A. J. (1983). Gastrointestinal manifestations of systematic vasculitis. In Quarterly Journal of Medicine (206 ed., Vol. 52, pp. 141-149)

Gastrointestinal manifestations of systematic vasculitis. / Camilleri, Michael; Pusey, C. D.; Chadwick, V. S.; Rees, A. J.

Quarterly Journal of Medicine. Vol. 52 206. ed. 1983. p. 141-149.

Research output: Chapter in Book/Report/Conference proceedingChapter

Camilleri, M, Pusey, CD, Chadwick, VS & Rees, AJ 1983, Gastrointestinal manifestations of systematic vasculitis. in Quarterly Journal of Medicine. 206 edn, vol. 52, pp. 141-149.
Camilleri M, Pusey CD, Chadwick VS, Rees AJ. Gastrointestinal manifestations of systematic vasculitis. In Quarterly Journal of Medicine. 206 ed. Vol. 52. 1983. p. 141-149
Camilleri, Michael ; Pusey, C. D. ; Chadwick, V. S. ; Rees, A. J. / Gastrointestinal manifestations of systematic vasculitis. Quarterly Journal of Medicine. Vol. 52 206. ed. 1983. pp. 141-149
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