Gallbladder vasculitis: a report of two cases

Abstract

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Single-organ gallbladder vasculitis: Characterization and distinction from systemic vasculitis involving the gallbladder. An analysis of 57 patients

“…Mean duration of GB-related (right-upper quadrant or abdominal) symptoms was 9.5 weeks (median, 1 wk; range, 0-60 wk) prior to diagnosis. Lithiasic cholecystitis and/or chronic cholelithiasis was the clinical presentation in 44% of patients, 3,4,11,14,17,19,31,34,38,40,46,48,50,51,61 45.7% presented with acalculous cholecystitis, 1,3,5,12,16,18,20,22,23,28,32,36 -38, 42-48,51,58-60 3.4% with bile duct obstruction, 10,15 and 6.7% did not exhibit abdominal symptoms; GV was discovered because of abnormal GB findings in imaging studies, 9,38 exploratory laparotomy (current study Patient 5), or necropsy. 56 GB-related manifestations were the only expression of GV in 20 (33%) patients.…”

“…9,10,12,37,46,54 GB-SOV was found in 20 (33%) patients and GB-SV in 41 (67%). Forms of SV that affected the GB were PAN (n ¼ 10), 4,12,22,32,38,45,46,51,54 HBV-associated vasculitis (n ¼ 8), 10,11,17,38,46,56,60 cryoglobulinemic (essential or HCVassociated) vasculitis (n ¼ 6), 9,14,19,36,50 MPA (n ¼ 4), 5,31,38,40 EGPA (Churg-Strauss) (n ¼ 4), 20,43,48,61 IgA vasculitis (Henoch-Schönlein) (n ¼ 2), 23,28 giant cell arteritis (n ¼ 1), 47 and vasculitis associated with autoimmune diseases (n ¼ 6) 11,16,18,42,58 (see Table 4). Systemic diseases with associated vasculitis included RA (n ¼ 3), 11,16,18 SLE (n ¼ 2), 42,58 and systemic sclerosis (n ¼ 1).…”

“…1,37 Fibrinoid necrosis was described in 43 patients, 15 with GB-SOV (75%) and 28 with GB-SV (68.3%). The presence of a healed inflammatory pattern was often observed with acute lesions in the same biopsy in both GB-SV 9,19,38,43,51 and GB-SOV. 19,34,44,59 Artery aneurysms due to vasculitis have been reported in patients with GB-SOV.…”

“…The presence of a healed inflammatory pattern was often observed with acute lesions in the same biopsy in both GB-SV 9,19,38,43,51 and GB-SOV. 19,34,44,59 Artery aneurysms due to vasculitis have been reported in patients with GB-SOV. 3,44 No malignant lesions accompanied GV.…”

“…10,12,46 Among GB-SV patients, 23 (59%) had a biopsy performed in regions other than the GB [9][10][11]14,19,23,32,36,38,40,42,43,45,46,48,50,51,54,60,61 and 82% of them confirmed vasculitis. SV (including GV) was diagnosed at necropsy in 1 patient.…”