• Case report
• Granulomatosis with polyangiitis
• Intestinal perforation
• Management
• Pancytopenia

• Humans
• Granulomatosis with Polyangiitis/complications
• Granulomatosis with Polyangiitis/drug therapy
• Granulomatosis with Polyangiitis/diagnosis
• Female
• Intestinal Perforation/etiology
• Intestinal Perforation/surgery
• Adult
• Pancytopenia/etiology
• Pancytopenia/therapy
• Immunosuppressive Agents/therapeutic use
• Treatment Outcome
• Jejunal Diseases/etiology

Systemic vasculitis associated with antineutrophil cytoplasmic autoantibodies (ANCA) have an extremely wide variety of symptoms, therefore the fast and proper diagnosis is difficult to establish even for experienced physicians. Gastrointestinal manifestations in ANCA-associated granulomatosis with polyangiitis (GPA) may be present, however, severe, life-threatening complications (such as perforations) are rare.

A case of an 18-year-old male patient is presented, where gastrointestinal symptoms (abdominal pain, vomiting, diarrhoea) were the first remarkable signs of GPA. The initial diagnosis of inflammatory bowel disease delayed the administration of proper immunosuppressive therapy, which might have contributed to the rare and life-threatening complication of arterial duodenal bleeding with perforation. Our systematic review of the literature found only a few case reports where gastrointestinal symptoms were the first signs of GPA, however, this entity might be more frequent if physicians would think of this possibility more often.

Gastrointestinal bleeding is a rare but potential lethal complication of vasculitis. Consequently, we recommend investigating the patients diagnosed with GPA for gastrointestinal bleeding during the treatment.

• Antineutrophil cytoplasmic antibodies
• Case report
• Gastrointestinal haemorrhage
• Granulomatosis with polyangiitis
• Systemic vasculitis

Granulomatosis with polyangiitis (GPA) commonly affects upper/lower respiratory tract and kidneys. It causes necrotizing vasculitis of small and medium-sized blood vessels. Gastrointestinal (GI) involvement is an uncommon manifestation of GPA, and presentation with predominant GI manifestation is noteworthy. We report a case of 50-year-old male with melena due to GI vasculitis along with other systemic involvement. The patient was treated with pulse methylprednisolone, cyclophosphamide, and plasmapheresis. To manage the refractory GI bleed, the patient underwent surgical resection, and the histology of the surgical specimen confirmed necrotizing vasculitis.

• ANCA vasculitis
• gastrointestinal manifestation
• granulomatosis with polyangiitis