Abstract | BACKGROUND: CASE SUMMARY: We present the case of a 61-year-old woman diagnosed with granulomatosis with polyangiitis based on the presence of symptoms in ear, lung, and, kidney with positive myeloperoxidase- antineutrophil cytoplasmic antibody. She received pulsed methylprednisolone followed by prednisolone 55 mg/d and intravenous CPA at a dose of 500 mg/mo. Ten days after the second course of intravenous CPA, she developed nausea, vomiting, and diarrhea, and was admitted to the hospital. Laboratory testing revealed hypoalbuminemia, suggesting protein-losing enteropathy. Computed tomography revealed wall thickening of the stomach, small intestine, and colon with contrast enhancement on the lumen side. Antibiotics and immunosuppressive therapy were not effective, and the patient's enteritis did not improve for > 4 mo. Because her condition became seriously exhausted, corticosteroids were tapered and supportive therapies including intravenous hyperalimentation, replenishment of albumin and gamma globulin, plasma exchange, and infection control were continued. These supportive therapies improved her condition, and her enteritis gradually regressed. She was finally discharged 7 mo later. CONCLUSION: Immediate discontinuation of CPA and intensive supportive therapy are crucial for the survival of patients with CPA-associated severe enteritis.
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Authors | Hiroko Sato, Tsuyoshi Shirai, Hiroshi Fujii, Tomonori Ishii, Hideo Harigae |
Journal | World journal of gastroenterology
(World J Gastroenterol)
Vol. 27
Issue 20
Pg. 2657-2663
(May 28 2021)
ISSN: 2219-2840 [Electronic] United States |
PMID | 34092982
(Publication Type: Case Reports)
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Copyright | ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. |
Chemical References |
- Cyclophosphamide
- Peroxidase
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Topics |
- Cyclophosphamide
(adverse effects)
- Enteritis
(chemically induced, diagnosis, drug therapy)
- Female
- Granulomatosis with Polyangiitis
(complications, diagnosis, drug therapy)
- Humans
- Middle Aged
- Peroxidase
- Protein-Losing Enteropathies
(chemically induced, diagnosis, drug therapy)
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