• Internal medicine · Sep 2021

    Case Reports

    A Ruptured Jejunal Arterial Aneurysm in a Young Woman Undergoing Chronic Hemodialysis Due to Myeloperoxidase-antineutrophil Cytoplasmic Antibody-associated Vasculitis.

    • Masataka Murakawa, Shigeyuki Arai, Mika Kawagoe, Yoshihiro Tomomitsu, Kohei Odajima, Masaki Ueno, Shinichiro Asakawa, Daigoro Hirohama, Michito Nagura, Osamu Yamazaki, Yoshifuru Tamura, Shunya Uchida, Shigeru Shibata, and Yoshihide Fujigaki.
    • Department of Internal Medicine, Teikyo University School of Medicine, Japan.
    • Intern. Med. 2021 Sep 15; 60 (18): 2939-2945.

    AbstractA 21-year-old woman was admitted to our hospital because of massive intestinal bleeding. She started hemodialysis due to myeloperoxidase antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) at 18 years of age. Her ANCA titers remained stable; however, her C-reactive protein increased on 5 mg/day prednisolone before admission. Computed tomography angiography revealed a ruptured jejunal arterial aneurysm. Transcatheter arterial embolization, blood transfusion and the reinforcement of steroid therapy resolved her symptoms of AAV. Our case of a young patient with AAV and medium-sized arterial vasculitis is rare and emphasizes that the ANCA titer does not always rise, especially in patients with nonrenal vasculitis flare-ups.

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