Arterial Aneurysms in Wegenerapos;s Granulomatosis: Case Report and Literature Review.

OBJECTIVE: Arterial aneurysms are characteristic of medium-size vessel vasculitis but are a very unusual feature of Wegeneramp;apos;s granulomatosis (WG). We describe a typical WG case, complicated by arterial aneurysms and review previously reported cases.

METHODS: Medline database search of cases published between January 1978 and July 2006, in English, reporting arterial aneurysms complicating WG.

RESULTS: Five years after diagnosis, a 29-year-old man with typical WG developed macro- and microaneurysms located on branches of the hepatic and renal arteries during a disease relapse. The main symptoms were abdominal pain, vomiting, and altered general status. He was successfully treated by coil embolization in combination with prednisone, intravenous mycophenolate mofetil, and high-dose immunoglobulins. Twelve additional cases of WG complicated by arterial aneurysms are reported in the English literature. This represents a life-threatening complication since rupture occurred in half of the patients.

CONCLUSIONS: Although small-vessel injury predominates in WG, inflammation of medium-size arteries may occur and lead to aneurysm formation. Abdominal angiography should be recommended when unexplained abdominal pain occurs during a WG flare.
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