SHM Converge Scientific Abstract ePoster Gallery-A Pronounced and Atypical Presentation of Granulomatosis With Polyangiitis

A Pronounced and Atypical Presentation of Granulomatosis With Polyangiitis

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The patient was diagnosed with granulomatosis with polyangiitis (GPA) involving the skin, kidneys, sinuses, and nerves. Treatment was started promptly with pulse-dose steroids and rituximab. Because of severe digital ischemia, additional therapies were used, including amlodipine, aspirin, sildenafil, nitropaste, pentoxifylline, and plasmapheresis. Several surgical teams evaluated her fingers, but no intervention was possible.<br /><br />Her hospital course was complicated by an acute gastrointestinal bleed that required blood transfusion and intensive care. Endoscopy identified multiple small bowel ulcers, which were attributed to vasculitis. The bleeding improved after antiplatelet and anticoagulant medications were stopped and rituximab was continued.<br /><br />Over time, her symptoms gradually improved, and she was discharged with close outpatient follow-up.

Asset Subtitle

Scott Meyer

Meta Tag

Author List Alexandra Gordon, Benjamin Verplanke, Cindy Fang, Scott Meyer

Category Clinical Vignettes

Concept Granulomatosis with Polyangiitis

Concept Vasculitis

Concept Immunosuppressive Therapy

Concept Pulse-Dose Steroids

Concept Rituximab

Distinguished Non-Finalist

Presenter Organization NYU Langone Health

Presenting Author Scott Meyer

Track Adult

Keywords

granulomatosis with polyangiitis

GPA

vasculitis

digital ischemia

rituximab

pulse-dose steroids

plasmapheresis

gastrointestinal bleed

small bowel ulcers

blood transfusion

Granulomatosis with Polyangiitis

Vasculitis

Immunosuppressive Therapy

Pulse-Dose Steroids

Rituximab