Korean J Gastroenterol.  2010 May;55(5):331-335. 10.4166/kjg.2010.55.5.331.

A Case of Limited Wegener's Granulomatosis with Gastroenteritis and Mesenteric Lymphadenopathy

• Jeong YG
• Kim TH
• Lee CM
• Shim KS
• Moon IK
• Lee SI
• Jung WT
• Lee OJ

• KMID: 1718339
• DOI: http://doi.org/10.4166/kjg.2010.55.5.331

Abstract

Wegener's granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis.

Keyword

Wegener's granulomatosis; Vasculitis; Gastrointestinal tract; Mesenteric lymphadenopathy

MeSH Terms

Aged
Anti-Inflammatory Agents/therapeutic use
Colonoscopy
Diagnosis, Differential
Gastroenteritis/complications/*diagnosis
Humans
Lymphatic Diseases/complications/*diagnosis/pathology
Male
Prednisolone/therapeutic use
Tomography, X-Ray Computed
Wegener Granulomatosis/complications/*diagnosis/drug therapy

Figure

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  Fig. 1. Abdominal CT scan. It showed (A) multiple distal mesenteric lymph nodes enlargement (arrows) and (B) segmental small bowel wall thickening (arrows).

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  Fig. 2. Colonoscopic findings. It showed diffuse bowel wall edema and submucosal hemorrhages.

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  Fig. 3. Microscopic findings of specimen. (A) Mesenteric lymph nodes showed vasculitis (arrow heads) with granulomatous inflammation (arrow) (H&E stain, ×100). (B) Mesenteries showed necrotizing vasculitis with small sized vessel (H&E stain, ×200).

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  Fig. 4. Post-treatment abdominal CT scan. Mesenteric lymph nodes enlargement and bowel wall thic-kenings disappeared.

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