A Case of Hemocholecystitis in a Patient with Microscopic Polyangiitis.
- Author:
Ji Suk HAN
1
;
Sung Yeon LEE
;
Hyung Jik KIM
;
Young Rim SONG
;
Jwa Kyung KIM
;
Eun Yeong HONG
;
Soo Ki MIN
Author Information
1. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Seoul, Korea. everlover7@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Hemocholecystitis;
Microscopic polyangiitis;
Vasculitis
- MeSH:
Abdominal Pain;
Acalculous Cholecystitis;
Anti-Bacterial Agents;
Antibodies, Antineutrophil Cytoplasmic;
Arteries;
Biopsy;
Cholecystectomy;
Cholecystitis;
Female;
Glomerulonephritis;
Granuloma;
Hemorrhage;
Hospitalization;
Humans;
Microscopic Polyangiitis;
Middle Aged;
Necrosis;
Pneumonia;
Thorax;
Urinary Bladder;
Vasculitis
- From:Korean Journal of Medicine
2012;83(1):127-131
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Microscopic polyangiitis (MPA) is a systemic necrotizing vasculitis, primarily associated with rapidly progressive glomerulonephritis and alveolar hemorrhage. Approximately 50% of MPA cases are associated with gastrointestinal involvement, but rarely do cases involve the gall bladder. We report an unusual case of MPA complicated by hemocholecystitis. A 62-year-old woman was admitted to our hospital with rapidly progressive renal dysfunction and pneumonia unresponsive to antibiotics. A chest CT scan showed bilateral diffuse alveolar consolidation, and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) staining was positive. During the course of hospitalization, the patient complained of severe abdominal pain, and an abdominal CT scan revealed acalculous cholecystitis with hemorrhage. Cholecystectomy was performed, and a gall bladder biopsy revealed fibrinoid necrosis of small arteries without granuloma. Cholecystitis should be considered in patients with unexplained upper abdominal pain and MPA.
