ТЯЖЕЛОЕ ЖЕЛУДОЧНО-КИШЕЧНОЕ КРОВОТЕЧЕНИЕ КАК ПРОЯВЛЕНИЕ ГРАНУЛЕМАТОЗНОГО ПОЛИАНГИИТА (ГРАНУЛЕМАТОЗА ВЕГЕНЕРА)
Abstract
Granulomatosis with polyangiitis (Wegener’s granulomatosis) (GPA) is a primary vasculitis of unknown origin characterised by granulomatous necrotising inflammation of small arteries and veins. The Chapel Hill Consensus classified GPA as small-vessel vasculitis with the presence of anti-neutrophil cytoplasmic antibodies (cANCA). Classical manifestation of the disease described by Wegener in 1936 includes upper and lower respiratory tract involvement and glomerulonephritis, it can affect every other organ. This results in heterogeneity of clinical manifestations. Although gastrointestinal tract involvement is rare, both the small and the large bowel may be involved, thus causing a serious complication of GPA
About the Authors
Н. Фролова
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
М. Ветшева
ГБОУ ВПО Первый МГМУ им. И.М. Сеченова МЗ РФ
Russian Federation
Russian Federation
К. Лосс
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
О. Подкорытова
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
Г. Волгина
3МГМСУ им. А. И. Евдокимова
Russian Federation
Russian Federation
О. Брацун
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
Н. Воронова
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
И. Назарова
ГБУЗ «ГКБ № 52 ДЗМ»
Russian Federation
Russian Federation
References
1. Jennette J.C., Falk R.J., Bacon P.A. et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides - Arthritis Rheum. - 65 (1): 2013; 1-11
2. Nadeau SE. Neurologic manifestations of systemic vasculitis. Neurol Clin. 2002; 20 (1):123-150
3. Grant SC, Levy RD, Venning MC, Ward C, Brooks NH. Wegener's granulomatosis and the heart. Br Heart J. 1994; 71 (1):82-86
4. Бекетова Т.В. АНЦА-ассоциированные системные васку- литы. Под редакцией академика РАН Насонова Е.Л. Москва, 2015 46-48 с./ENG
5. Strivens RL, Bateman A, Arden NK, Edwards CJ. Intestinal perforation and jejunal haemorrhage due to Wegener's granulomatosis. Clin Exp Rheumatol. 2005; 23 (1):124
6. Geraghty J, Mackay IR, Smith DC. Intestinal perforation in Wegener's granulomatosis. Gut. 1986; 27(4):450-451
7. Akca T, Colak T, Caglikulekci M, Ocal K, Aydin S. Intestinal perforation in Wegener's granulomatosis: a case report. Ulus Travma Derg. 2005; 11 (4):348-351
8. Watts RA, Lane SE, Bentham G, Scott DGI Epidemiology of systemic vasculitis - a 10-year study. - Arthritis Rheum 2000; 43: 4 22-427
9. Fujimoto S, Watts R, Kobayashi S, et al. Comparison of the epidemiology of anti-neutrophil cytoplasmic antibodyassociated vasculitis between Japan and the UK. -Rheumatology 2011; 50:1916-1920
10. Бекетова Т.В. АНЦА-ассоциированный системный васку- лит. Нефрология. Национальное руководство/гл.ред.Н.А.Мухин. - М.: ГЭОТАР-Медиа, 2014
11. Hilhorst М. et al. Connective tissue growth factor and the cicatrization of cellular crescents in ANCA-associated glomerulonephritis. - NDT. Volume 30, Issue 8 Pp. 1291-1299
12. Lionaki, S. et al. Classification of antineutrophil cytoplasmic autoantibody vasculitides: the role of antineutrophil cytoplasmic autoantibody specificity for myeloperoxidase or proteinase 3 in disease recognition and prognosis. - Arthritis Rheum. 64, 2012; 3452-3462
13. Lyons, P. A. et al. Genetically distinct subsets within ANCA- associated vasculitis. N. - Engl. J. Med. 367, 214-223 (2012)
14. Merkel P.A. et al. The OMERACT core set of outcome measures for use in clinical trials of ANCA-associated vasculitis. - J Rheumatol. 2011 Jul;38(7):1480-6. doi: 10.3899/jrheum.110276
15. Pagnoux C, Hogan S, Chin H, et al. Predictors of treatment resistance and relapse in antineutrophil cytoplasmic antibody- associated small-vessel vasculitis: Comparison of two independent cohorts. - Arthritis Rheum. 2008;58:2908-18. doi: 10.1002/art.23800
16. Pagnoux C, Mahr A, Cohen P, Guillevin L. Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis. Medicine (Baltimore) 2005; 84 (2):115-128
17. Prz Gastroenterol . 2016; 11 (4): 270-275, 10.5114 / pg.2016.57887
18. Sahin M, Cure E, Goren I, et al. Wegener’s granulomatosis presenting with acute renal failure and gastric ulcer. Case Rep Clin Prac Rev. 2006; 7:236-9
Review
For citations:
, , , , , , , . Moscow Surgical Journal. 2017;(3):34-39. (In Russ.)
Views:
362
Email this article 