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Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties
We report the case of a 57-year-old Caucasian man who presented with dry cough, haemoptysis, fever, lung nodules, erythrocyturia, and acute hepatitis. After a lung biopsy, the patient was diagnosed with granulomatosis with polyangiitis. The diagnosis was supported by the presence of anti-proteinase-...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825971/ https://www.ncbi.nlm.nih.gov/pubmed/29491541 http://dx.doi.org/10.5114/reum.2017.72630 |
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author | Masiak, Anna Drobińska, Anna Zdrojewski, Zbigniew |
author_facet | Masiak, Anna Drobińska, Anna Zdrojewski, Zbigniew |
author_sort | Masiak, Anna |
collection | PubMed |
description | We report the case of a 57-year-old Caucasian man who presented with dry cough, haemoptysis, fever, lung nodules, erythrocyturia, and acute hepatitis. After a lung biopsy, the patient was diagnosed with granulomatosis with polyangiitis. The diagnosis was supported by the presence of anti-proteinase-3 anti-neutrophil cytoplasmic antibodies. The most common causes of liver damage are excluded. The patient was treated with prednisone and cyclophosphamide, which resulted in remission of chest CT findings and improvement in liver function tests. During the flare, new lung infiltrations as well as elevation of liver enzymes were present. Treatment with rituximab resulted in complete clinical and radiological remission and normalisation of liver function tests. What makes this case worth reporting is the rare liver involvement in the GPA. After exclusion of coexistence of autoimmune liver disease and drug-induced liver lesion, organ involvement was supported by the reversion of abnormal LFT after the immunosuppression of GPA. |
format | Online Article Text |
id | pubmed-5825971 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie |
record_format | MEDLINE/PubMed |
spelling | pubmed-58259712018-02-28 Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties Masiak, Anna Drobińska, Anna Zdrojewski, Zbigniew Reumatologia Case Report We report the case of a 57-year-old Caucasian man who presented with dry cough, haemoptysis, fever, lung nodules, erythrocyturia, and acute hepatitis. After a lung biopsy, the patient was diagnosed with granulomatosis with polyangiitis. The diagnosis was supported by the presence of anti-proteinase-3 anti-neutrophil cytoplasmic antibodies. The most common causes of liver damage are excluded. The patient was treated with prednisone and cyclophosphamide, which resulted in remission of chest CT findings and improvement in liver function tests. During the flare, new lung infiltrations as well as elevation of liver enzymes were present. Treatment with rituximab resulted in complete clinical and radiological remission and normalisation of liver function tests. What makes this case worth reporting is the rare liver involvement in the GPA. After exclusion of coexistence of autoimmune liver disease and drug-induced liver lesion, organ involvement was supported by the reversion of abnormal LFT after the immunosuppression of GPA. Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie 2017-12-30 2017 /pmc/articles/PMC5825971/ /pubmed/29491541 http://dx.doi.org/10.5114/reum.2017.72630 Text en Copyright: © 2017 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Case Report Masiak, Anna Drobińska, Anna Zdrojewski, Zbigniew Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title | Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title_full | Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title_fullStr | Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title_full_unstemmed | Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title_short | Hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
title_sort | hepatic involvement in granulomatosis with polyangiitis – diagnostic difficulties |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825971/ https://www.ncbi.nlm.nih.gov/pubmed/29491541 http://dx.doi.org/10.5114/reum.2017.72630 |
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