Localized vasculitis of the gastrointestinal tract: a case series

Abstract

LVGT is an uncommon form of vasculitis that can be associated with significant morbidity and mortality.

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

“…Six patients were identified by the Cleveland Clinic database search and 55 patients from the PubMed search. Originally, 83 cases were identified as GV in the literature; however, 28 patients were excluded: 15 patients from a single study, 6 1 patient with IgA vasculitis (Henoch-Schönlein), 35 and 4 with Kawasaki disease 13 did not have sufficient data and 8 cases classified as GB-SOV in whom inadequate follow-up 3,29,38,44,54 or an initial treatment with glucocorticoids and/or cytotoxic agents 33,42 could not guarantee the extent of GV. In addition, 3 patients previously diagnosed with autoimmune diseases (1 each with systemic lupus erythematosus [SLE], 42 rheumatoid arthritis [RA], 42 and mixed connective tissue disease 33 ) did not have involvement of other tissues at the time of GV diagnosis.…”

“…6,21 However, gastrointestinal SOV may have an increased risk of death, similar to that seen in SV. 46,54 Of note, GB-SOV patients do not require any treatment apart from GB excision and do not seem to have an increased mortality. Conversely, all GB-SV patients require glucocorticoid therapy, and most of them require an additional immunosuppressive agent.…”

“…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.…”

“…Whether it is part of SV or SOV, bowel vasculitis is associated with a high risk of severe morbidity and mortality. 46,54 GB vasculitis (GV) has been described in 8%-40% of patients with PAN 11,46 and in fewer than 2% of patients with other forms of SV. 46 GV has also been reported in patients with autoimmune diseases, 6,11,33,42,58 and some authors have attributed a worse prognosis to patients with GV and surrogate markers of autoimmunity.…”