RT Journal Article
SR Electronic
T1 Cutaneous vasculitis - a case for laparotomy?
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1621
OP 1623
VO 30
IS 7
A1 Lisa Willcocks
A1 Gladstone Chelliah
A1 Rachel Brown
A1 Paul Bacon
YR 2003
UL http://www.jrheum.org/content/30/7/1621.abstract
AB The diagnosis of gut vasculitis infers a poor prognosis necessitating aggressive therapy. We describe a case with predominant features of a skin-limited vasculitis but atypical debilitating abdominal symptoms. Although endoscopic biopsies were unremarkable, full thickness biopsy taken at laparotomy revealed a necrotizing vasculitis. After treatment with cyclophosphamide, the previously resistant abdominal symptoms resolved. This case illustrates the need to tailor treatment to disease severity, rather than determine it by the type of vasculitis with which the patient has been labelled. In view of the importance of gastrointestinal involvement to therapy decisions, laparotomy may be necessary to establish the presence of vasculitis.