Chapter 8 Gastrointestinal Involvement in Systemic Vasculitis

Abstract

Publisher Summary This chapter discusses the gastrointestinal (GI) involvement in systemic vasculitis. GI manifestations of systemic vasculitides (SVs) are a challenge for the clinician because of the variety and severity of individual vasculitis, ranging from isolated involvement to life-threatening disease related to massive intestinal disease. It is necessary to distinguish between primary and secondary vasculitis, while considering the differential diagnosis. Acute intestinal vasculitis is an evolving disease with intensive abdominal pain, followed by signs of peritonitis and ileus. Takayasu's arteritis (TA) is an acute arteritis affecting the large and medium vessels, and is characterized by signs and symptoms of stenosis of aortic branches. Giant cell arteritis (GCA) is a chronic, systemic vasculitis with a distinct localization in large- and medium-sized arteries. The most serious complications of GCA are persistent and permanent visual loss or neurologic damage. Prognosis depends on its major localizations. Polyarteritis nodosa (PAN) and Kawasaki disease (KD) are the two major forms of medium-sized vessel vasculitis (MVV), characterized by necrotizing arteritis. Gastroscopy and colonoscopy, at times, reveal signs of colitis or multiple petechiae or small mucosal ulcers, whereas chronic intestinal vasculitides are associated with important morbidity and mortality.