Gastrointestinal symptoms and granulomatous vasculitis involving the liver in giant cell arteritis: a case report and review of the literature

Lee, Sindy; Childerhouse, Anna; Moss, Kate

doi:10.1093/rheumatology/ker278

Cited by 12 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Elevated serum alkaline phosphatase and transaminases, suggesting liver involvement in GCA have been reported. These normalised with corticosteroid treatment suggesting inflammatory involvement [98,99]. Gallbladder involvement has also been documented [100].…”

Section: The Gastrointestinal and Renal Systemsmentioning

confidence: 99%

Giant cell arteritis: ophthalmic manifestations of a systemic disease

Smit

O’Sullivan

Mackey

et al. 2016

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

Section: The Gastrointestinal and Renal Systemsmentioning

confidence: 99%

Giant cell arteritis: ophthalmic manifestations of a systemic disease

Smit

O’Sullivan

Mackey

et al. 2016

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

“…In this entity, asymptomatic raised liver function tests in patients with GCA are frequent, but symptomatic liver involvement is extremely rare [24]. Another study showed an association of autoimmune liver diseases such as PSC, PSC, and AIH with various small vessel vasculitides.…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Gut and Liver in Vasculitic Disorders

Müller‐Ladner

2016

Dig Dis

View full text Add to dashboard Cite

Background: Although the gastrointestinal (GI) tract including its related organs is not generally regarded as one of the primary organ systems of primary and secondary vasculitic disorders, there are numerous mechanisms of these diseases operative in or around the different structures and compartments of the GI tract. Key Messages: A majority of the respective clinical symptoms and problems are linked to an alteration of (peri)vascular homeostasis. Alteration of perivascular matrix metabolism can also affect the functional integrity and motility of the GI tract. Apart from the specific GI phenomena of the individual diseases as outlined in detail in this review, the epidemiology of GI involvement follows in general the characteristics of the respective underlying systemic disease. In addition, gender and age do neither influence the occurrence nor the severity of the GI manifestations significantly. With respect to clinical symptoms, vasculitides may result in abdominal pain, bleeding, ileus, intestinal necrosis and hematochezia because of reduced blood flow and hyper-acute occlusion in the antiphospholipid syndrome. Small-bowel involvement in vasculitic entities can cause pseudoobstruction, obstruction, malabsorption and bacterial overgrowth. Laboratory parameters can point to specific diseases but are frequently nonspecific. Thus, if biopsy fails or in unclear endoscopic situations, a variety of imaging techniques including Doppler ultrasound, abdominal CT, MRI and angiography are used and required for identification and localization of the underlying disease. Therapeutic strategies in vasculitides usually include corticosteroids and immunosuppressants, for example, cyclophosphamide in granulomatosis with polyangiitis and in panarteriitis nodosa but also biologics such as rituximab in ANCA-associated vasculitides. Virostatic drugs including interferon-α and ribavirin can be used in hepatitis B- and C-triggered vasculitides such as panarteriitis nodosa and hepatitis C-associated cryoglobulinemia. Conclusions: Immediate diagnostic and therapeutic steps of action need to be performed if vasculitis of the GI tract is suspected in order to avoid irreversible damage to organs and to improve the well-being and life of the affected patient.

show abstract

“…A multitude of studies have shown that up to one-third of patients with GCA may have asymptomatic liver enzyme abnormalities, especially elevation of alkaline phosphatase and GGT [63] . Mesenteric vessels are rarely affected in GCA, but when it occurs, it may lead to bowel ischemia [64] . Hepatic artery vasculitis [65] and coexisting granulomatosis hepatitis have been observed in some studies [66] .…”

Section: Giant Cell Arteritismentioning

confidence: 99%

Abdominal involvement as a primary manifestation of systemic or isolated gastrointestinal vasculitis

Gheriani,

Lenert

2024

Vessel Plus

View full text Add to dashboard Cite

Systemic vasculitides can cause a wide variety of gastrointestinal manifestations (GI) ranging from mild and frequently nonspecific abdominal pains to potentially life-threatening bowel perforations. Vascular involvement in systemic vasculitides can affect any GI blood vessel, most commonly mesenteric, hepatic, or splenic arteries. Inflammatory changes affecting different layers of arterial vessel walls can lead to aneurysmatic dilatation or blood vessel occlusion with subsequent organ ischemia leading to mucosal ulcerations, GI bleeding, perforations, or bowel obstruction. While the presence of extraintestinal manifestations may aid in diagnosis, delays in making appropriate diagnoses and rapid initiation of glucocorticoid and immunosuppressive treatment can have detrimental consequences. Awareness of isolated gastrointestinal vasculitis is of particular importance as it frequently remains undiagnosed until end-stage organ damage becomes apparent. Vasculitis mimics such as vascular Ehlers-Danlos syndrome or fibromuscular dysplasia add another lay of complexity in approaching patients with suspected GI vasculitis and should always be carefully considered.

show abstract

Gastrointestinal symptoms and granulomatous vasculitis involving the liver in giant cell arteritis: a case report and review of the literature

Cited by 12 publications

References 10 publications

Giant cell arteritis: ophthalmic manifestations of a systemic disease

Giant cell arteritis: ophthalmic manifestations of a systemic disease

Gut and Liver in Vasculitic Disorders

Abdominal involvement as a primary manifestation of systemic or isolated gastrointestinal vasculitis

Contact Info

Product

Resources

About