Acute Pancreatitis as a First Presentation of Granulomatosis With Polyangiitis

Michael Youssef; Mary Sedarous; Andrea Grin; Andrew Chung; Lawrence Hookey

doi:10.14309/crj.0000000000000986

Acute Pancreatitis as a First Presentation of Granulomatosis With Polyangiitis

ACG Case Rep J. 2023 Feb 10;10(2):e00986. doi: 10.14309/crj.0000000000000986. eCollection 2023 Feb.

Authors

Michael Youssef¹, Mary Sedarous², Andrea Grin³, Andrew Chung⁴, Lawrence Hookey²

Affiliations

¹ Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
² Division of Gastroenterology, Kingston Health Sciences Centre, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.
³ Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.
⁴ Department of Radiology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada.

Abstract

Granulomatosis with polyangiitis (GPA) is a rare necrotizing antineutrophil cytoplasmic antibody-associated vasculitis characterized by inflammation in small-sized arteries. Gastrointestinal involvement is exceedingly rare in GPA. Here, we present a case of recurrent acute pancreatitis as the initial presentation of GPA. The diagnosis was made based on radiological and pathological findings of acute pancreatitis in conjunction with positive anti-PR3 antibody which is strongly associated with GPA. Systemic vasculitides are rare but important to consider in cases of idiopathic acute pancreatitis. Early diagnosis and therapy allow for high rates of remission and improved survival rates.

Keywords: GPA; acute pancreatitis; anti-PR3:; endoscopic ultrasound; gastrointestinal manifestations of pancreatitis; granulomatosis with polyangiitis; recurrent acute pancreatitis; vasculitis.

Publication types

Case Reports