Rapidly progressive glomerulonephritis and intestinal perforation for microscopic polyangiitis

Abstract

Microscopic polyangeitis (MPA) is a necrotizing vasculitis which affects very small vessels, including small arterioles, capillaries, and venules, but principally glomerular capillaries and occasionally pulmonary capillaries. The gastrointestinal (GI) tract also may be involved in the MPA, with reported rates of 30%-56%. Clinically, the spectrum of GI symptoms is wide, ranging from mild transient abdominal pain to life-threatening complications requiring emergency surgery, for example, peritonitis, bowel infarction, or hemorrhage. However, massive intestinal bleeding is unusual in the natural history of MPA. Severe GI involvement has been identified as an independent factor associated with poor outcome for MPA.