ABSTRACT
The renal manifestations of systemic sclerosis include proteinuria, hypertension, azotemia, and renal crisis. Two types of scleroderma renal crisis (SRC) are recognized. Typical SRC is a syndrome consisting of acute-onset malignant hypertension accompanied by rapidly progressive renal failure, hypertensive retinopathy, and elevated plasma renin activity. The other type is normotensive renal failure, which is generally accompanied by antineutrophil cytoplasmic autoantibody (ANCA)-positive crescentic glomerulonephritis. A 51-year-old woman with scleroderma without marked dermatological change developed ANCA-related renal failure. She had neither malignant hypertension nor an elevated plasma rennin concentration. Renal biopsy showed crescentic glomerulonephritis (pauci-immune type), and the myeloperoxidase-specific ANCA (MPO-ANCA) titer was elevated at 1015 AAU. She was cured using steroid pulse therapy, combined with an angiotensin-converting-enzyme inhibitor and angiotensin-II receptor blocker
Subject(s)
Female , Humans , Middle Aged , Antibodies, Antineutrophil Cytoplasmic , Azotemia , Biopsy , Chymosin , Cytoplasm , Glomerulonephritis , Hypertension , Hypertension, Malignant , Hypertensive Retinopathy , Isonipecotic Acids , Plasma , Proteinuria , Renal Insufficiency , Renin , Scleroderma, SystemicABSTRACT
Arteriovenous malformation is a rare cause of lower gastrointestinal bleeding in patients younger than 50 years of age and is characterized by recurrent, painless, massive bleeding and chronic anemia without a remarkable prior or family history. The most commonly sites involved are the ascending colon and small bowel. This condition rarely involves the stomach and descending colon. Until recently, there has been only one case report on arteriovenous malformation of the descending colon in Korea. We report a case of a 32 year old male patient who presented with massive lower gastrointestinal bleeding and had been diagnosed with arteriovenous malformation of the descending colon after undergoing colonoscopy and abdomen CT with contrast enhancement. The patient underwent left hemicolectomy because of persistent bleeding despite conservative management.