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Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis
BACKGROUND/AIMS: Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. METHODS: Clinical characteristics, endoscopic features, an...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Editorial Office of Gut and Liver
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933413/ https://www.ncbi.nlm.nih.gov/pubmed/27226428 http://dx.doi.org/10.5009/gnl15198 |
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author | Gong, Eun Jeong Kim, Do Hoon Chun, Joo Hyun Ahn, Ji Yong Choi, Kwi-Sook Jung, Kee Wook Lee, Jeong Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong Kim, Jin Ho Song, In Hye Kim, Yong-Gil |
author_facet | Gong, Eun Jeong Kim, Do Hoon Chun, Joo Hyun Ahn, Ji Yong Choi, Kwi-Sook Jung, Kee Wook Lee, Jeong Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong Kim, Jin Ho Song, In Hye Kim, Yong-Gil |
author_sort | Gong, Eun Jeong |
collection | PubMed |
description | BACKGROUND/AIMS: Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. METHODS: Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. RESULTS: Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. CONCLUSIONS: Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low. |
format | Online Article Text |
id | pubmed-4933413 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Editorial Office of Gut and Liver |
record_format | MEDLINE/PubMed |
spelling | pubmed-49334132016-07-14 Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis Gong, Eun Jeong Kim, Do Hoon Chun, Joo Hyun Ahn, Ji Yong Choi, Kwi-Sook Jung, Kee Wook Lee, Jeong Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong Kim, Jin Ho Song, In Hye Kim, Yong-Gil Gut Liver Original Article BACKGROUND/AIMS: Gastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis. METHODS: Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records. RESULTS: Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis. CONCLUSIONS: Diagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low. Editorial Office of Gut and Liver 2016-07 2016-05-26 /pmc/articles/PMC4933413/ /pubmed/27226428 http://dx.doi.org/10.5009/gnl15198 Text en Copyright © 2016 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Gong, Eun Jeong Kim, Do Hoon Chun, Joo Hyun Ahn, Ji Yong Choi, Kwi-Sook Jung, Kee Wook Lee, Jeong Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong Kim, Jin Ho Song, In Hye Kim, Yong-Gil Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title | Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title_full | Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title_fullStr | Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title_full_unstemmed | Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title_short | Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis |
title_sort | endoscopic findings of upper gastrointestinal involvement in primary vasculitis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933413/ https://www.ncbi.nlm.nih.gov/pubmed/27226428 http://dx.doi.org/10.5009/gnl15198 |
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