In this case, we present a patient with an uncommon presentation of Granulomatosis with Polyangiitis (GPA) with hepatic involvement and the possible association with subclinical coeliac disease. We discuss the differential diagnosis and the relevant therapy.
A 71-year-old woman has been using corticosteroids since the age of 25. After a fall, she developed multiple compression fractures of the spine. Despite the obvious bone deformities during the physical examination in upper limbs, she denied any pain. Radiologic and a CT-scan evaluation revealed catastrophic lesions with a completely destroyed joint and many intra-articular free bodies. Long-term corticosteroid use can bring on catastrophic results in bone structures and patients must be properly informed regarding the side effects.
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