Recurrent gastrointestinal bleeding with ANCA associated glomerulonephritis successfully treated by transarterial embolization

摘要

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a group of autoimmune diseases that normally affects multiple organs. Recurrent gastrointestinal (GI) bleeding, a critical complication of AAV, remains a challenge. Here, we report a case of AAV complicated by pulmonary hemorrhage, severe recurrent gastrointestinal bleeding, and rapid progressive renal insufficiency that was treated successfully with selective transarterial embolization, continuous veno-venous hemofiltration, plasma exchange, intravenous gamma globulin infusion, followed by steroids and cytotoxic drug therapy. We report this case considering that selective transarterial embolization may be a safe and effective alternative method in recurrent AAV associated GI bleeding caused by AAV refractory to medical therapy.