SHM Converge Scientific Abstract ePoster Gallery-Unmasking Systemic Vasculitis: A Case of Melena and Acute Renal Failure Due to Pauci-Immune Crescentic Glomerulonephritis

Unmasking Systemic Vasculitis: A Case of Melena and Acute Renal Failure Due to Pauci-Immune Crescentic Glomerulonephritis

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This case highlights a rare but important link between gastrointestinal bleeding and pauci-immune crescentic glomerulonephritis. The patient presented with anemia, melena, and acute renal failure. Initial evaluation did not identify a clear gastrointestinal bleeding source. Further workup, including pill endoscopy, was also negative, suggesting that the bleeding and anemia were likely due to microvascular injury from systemic vasculitis rather than a focal GI lesion.<br /><br />The renal findings were consistent with crescentic glomerulonephritis, helping establish the cause of the acute kidney injury. Based on the overall picture, the patient was diagnosed with pauci-immune vasculitis affecting both the kidneys and the gastrointestinal tract. Treatment was started with prednisone and rituximab, and the patient was discharged with outpatient dialysis and nephrology follow-up.<br /><br />The main conclusion is that systemic vasculitis should be considered in patients with unexplained GI bleeding accompanied by renal dysfunction, especially when standard endoscopic evaluation does not reveal a source. Early diagnosis is critical because prompt immunosuppressive therapy, along with supportive care such as dialysis, may improve outcomes and prevent further organ damage.

Asset Subtitle

Nicole E. Green

Meta Tag

Author List Cecilia Heck, Nicole E. Green, Tyler Thorson

Category Clinical Vignettes

Concept Pauci-Immune Crescentic Glomerulonephritis

Concept Acute Renal Failure

Concept Systemic Vasculitis

Concept Microvascular Damage

Concept Immunosuppressive Therapy

Distinguished Non-Finalist

Presenter Organization University of Montana

Presenting Author Nicole E. Green

Track Adult

Keywords

gastrointestinal bleeding

pauci-immune vasculitis

crescentic glomerulonephritis

acute renal failure

anemia

melena

microvascular injury

systemic vasculitis

rituximab

prednisone

Pauci-Immune Crescentic Glomerulonephritis

Acute Renal Failure

Systemic Vasculitis

Microvascular Damage

Immunosuppressive Therapy