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KMID : 0882420120830010127
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Korean Journal of Medicine
2012 Volume.83 No. 1 p.127 ~ p.131
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A Case of Hemocholecystitis in a Patient with Microscopic Polyangiitis
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Han Ji-Suk
Lee Sung-Yeon
Kim Hyung-Jik
Song Young-Rim
Kim Jwa-Kyung
Hong Eun-Yeong
Min Soo-Ki
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Abstract
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Microscopic polyangiitis (MPA) is a systemic necrotizing vasculitis, primarily associated with rapidly progressive glomerulonephritis and alveolar hemorrhage. Approximately 50% of MPA cases are associated with gastrointestinal involvement, but rarely do cases involve the gall bladder. We report an unusual case of MPA complicated by hemocholecystitis. A 62-year-old woman was admitted to our hospital with rapidly progressive renal dysfunction and pneumonia unresponsive to antibiotics. A chest CT scan showed bilateral diffuse alveolar consolidation, and perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) staining was positive. During the course of hospitalization, the patient complained of severe abdominal pain, and an abdominal CT scan revealed acalculous cholecystitis with hemorrhage. Cholecystectomy was performed, and a gall bladder biopsy revealed fibrinoid necrosis of small arteries without granuloma. Cholecystitis should be considered in patients with unexplained upper abdominal pain and MPA.
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KEYWORD
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Hemocholecystitis, Microscopic polyangiitis, Vasculitis
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