Vascular thromboses with retroperitoneal fibrosis: a case report

Journal of Medical Case Reports - Tập 16 - Trang 1-8 - 2022
Hanane Charaf1, Rachida Zahraoui1, Mouna Soualhi1, Nezha Rguig1, Jamal Eddine Bourkadi1, Daoud Ali Mohamed2, Nasser Ittimad2
1Pneumo-Phtisiology Department, Faculty of Medicine and Pharmacy, Mohamed V University, Moulay Youssef Hospital, Rabat, Morocco
2Radiology Department, Faculty of Medicine and Pharmacy, Mohamed V University, Ibn Sina Hospital, Rabat, Morocco

Tóm tắt

Granulomatosis with polyangiitis is a systemic inflammatory disease characterized by necrotizing vasculitis that affects small- and medium-sized blood vessels. Granulomatous inflammation affects the lungs, ears, nose, and throat, and commonly affects the kidneys, although the retroperitoneal tissue is rarely affected. Several studies have reported an increased risk of venous thromboembolism. Early diagnosis and treatment are of vital importance due to the rapid progression of the disease. We present the case of a 66-year-old Moroccan man followed for bilateral jugular thrombosis. Cavitary pulmonary nodules and retroperitoneal fibrosis with thrombosis involving several vascular territories were detected on thoracoabdominopelvic computerized tomography scan. Laboratory analyses revealed that the patient was positive for cytoplasmic antineutrophilic antibodies. The diagnosis of granulomatosis with polyangiitis was retained. Treatment with glucocorticoids and immunosuppressive agents resulted in significant clinical and radiological improvement over the following months. We describe the diagnostic steps and the difficulty of managing this patient. Rare manifestations, such as retroperitoneal fibrosis, have been reported in the literature in association with granulomatosis with polyangiitis, and should not delay the diagnosis and treatment of granulomatosis with polyangiitis owing to its severity.

Tài liệu tham khảo

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