ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1767

Occurrence and Etiology of Gastrointestinal Perforation in Patients with Vasculitis

Vanessa L. Kronzer1, Daniel Larson2, Cynthia S. Crowson3,4, Kenneth J. Warrington5, Steven R. Ytterberg5, Ashima Makol4 and Matthew J. Koster4, 1Internal Medicine, Mayo Clinic, Rochester, MN, 2Pathology, Mayo Clinic, Rochester, MN, 3Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, MN, 4Rheumatology, Mayo Clinic, Rochester, MN, 5Rheumatology, Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ANCA, gastrointestinal complications, glucocorticoids, polyarteritis nodosa and vasculitis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, October 22, 2018

Session Title: Vasculitis – ANCA-Associated Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: This study aimed to characterize the presenting features and outcomes of patients with small- or medium-vessel vasculitis and gastrointestinal perforation.

Methods: Using a retrospective cohort design, we identified cases with verified granulomatosis with polyangiitis (GPA), eosinophilic GPA (EGPA), microscopic polyangiitis (MPA), or polyarteritis nodosa (PAN) by ACR criteria along with confirmed gastrointestinal perforation at our institution between 1998 and 2017. The standardized mortality ratio (SMR) was estimated using persons of the same age, sex, and calendar year derived from United States white population life tables.

Results: Over the twenty year time period, 20 total patients with small or medium-vessel vasculitis experienced bowel perforation. Three had EGPA, 11 GPA, three MPA, and three PAN. Four of the twenty cases experienced vasculitis-induced perforation. Cases with perforations due to vasculitic involvement had more small bowel involvement, longer duration of abdominal pain prior to perforation (41 days vs 0 days, p = 0.005), and a higher proportion of active tobacco use (75% vs 7%, p = 0.01) compared to the cases with non-vasculitis perforation.  A majority (88%) of the non-vasculitic-induced perforations were associated with glucocorticoid use. The median cumulative glucocorticoid dose at perforation in patients with additional, non-vasculitic risk factors for perforation was 4,320 mg prednisone and was 22,170 mg for those without such risk factors. Mortality rates for the whole cohort were higher than the general population (SMR 2.19, 95% confidence interval 1.05 to 4.02, Figure 1). The cases with vasculitis-induced perforation tended to have increased number of surgeries and length of stay; however, those differences failed to reach statistical significance.

Conclusion: In patients with known history of vasculitis, small bowel location and longer abdominal pain duration may help distinguish vasculitis-induced bowel perforation from other etiologies. Overall mortality in patients with vasculitis and bowel perforation is increased, highlighting the importance of a high index of suspicion and prompt management.


Disclosure: V. L. Kronzer, None; D. Larson, None; C. S. Crowson, None; K. J. Warrington, GlaxoSmithKline, 2,Eli Lilly and Co., 2,Sanofi, 5; S. R. Ytterberg, None; A. Makol, None; M. J. Koster, None.

To cite this abstract in AMA style:

Kronzer VL, Larson D, Crowson CS, Warrington KJ, Ytterberg SR, Makol A, Koster MJ. Occurrence and Etiology of Gastrointestinal Perforation in Patients with Vasculitis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/occurrence-and-etiology-of-gastrointestinal-perforation-in-patients-with-vasculitis/. Accessed March 7, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/occurrence-and-etiology-of-gastrointestinal-perforation-in-patients-with-vasculitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.