A case of allergic granulomatous angiitis diagnosed by colonoscopy

A 77-year-old man with a history of asthma presented with a 1-month-history of numbness of both lower thighs. In July 2013, the patient was hospitalized because of diarrhea and abdominal pain. Laboratory examination revealed leucocytosis with eosinophilia, increased serum immunoglobulin E levels, an...

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Veröffentlicht in:Progress of Digestive Endoscopy 2014/06/14, Vol.84(1), pp.152-153
Hauptverfasser: Namikawa, Ken, Takada, Yasuhiro, Shimura, Hiroto, Muto, Hidetomo, Kimura, Yuu, Ishida, Yasuo, Yamanaka, Taro, Ariizumi, Yasushi, Maeda, Ichiro, Hosaka, Masaki
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Sprache:eng ; jpn
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Zusammenfassung:A 77-year-old man with a history of asthma presented with a 1-month-history of numbness of both lower thighs. In July 2013, the patient was hospitalized because of diarrhea and abdominal pain. Laboratory examination revealed leucocytosis with eosinophilia, increased serum immunoglobulin E levels, and presence of rheumatoid factor. The test for myeloperoxidase-antineutrophil cytoplasmic antibodies was negative. Computed tomography showed wall thickening of the duodenum. Although upper gastrointestinal endoscopy revealed gastric ulcers and evidence of duodenitis, histopathologic examination did not reveal any granulomas or vasculitis. The patient developed purpura on both feet and reported bloody stools, therefore, colonoscopy was performed. There were multiple ulcers throughout the large intestine. These clinical findings were consistent with a diagnosis of Churg-Strauss syndrome. Colonoscopic biopsy revealed vasculitis with eosinophilic infiltration, and the diagnosis of allergic granulomatous angiitis was made. The patient was started on steroid treatment, following which his symptoms rapidly resolved and the eosinophil count decreased. The disease was well-controlled by systemic steroid therapy, and follow-up endoscopies showed improvement of both the mucosal and pathological manifestations.
ISSN:1348-9844
2187-4999
DOI:10.11641/pde.84.1_152