Antineutrophil cytoplasmic antibody-associated vasculitis with ruptured hepatic artery aneurysm because of acute hepatic injury due to hepatic artery ischemia: A case report

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  • Kurahashi Tomohide
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Hosui Atsushi
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Miyake Takayuki
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Hayata Naoko
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Okamoto Akino
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Aochi Kazuki
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Hirao Motohiro
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Yamada Takuya
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital
  • Hiramatsu Naoki
    Department of Gastroenterology and Hepatology, Osaka-Rosai Hospital

Bibliographic Information

Other Title
  • 肝動脈虚血による急性肝障害を契機に発見された肝動脈瘤破裂合併ANCA関連血管炎の1例
  • カン ドウミャクキョケツ ニ ヨル キュウセイ カン ショウガイ オ ケイキ ニ ハッケン サレタ カン ドウミャクリュウ ハレツ ガッペイ ANCA カンレン ケッカンエン ノ 1レイ

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Abstract

<p>An 85-year-old man with fever, cough, and elevated liver enzymes levels was referred to our hospital. Abdominal echocardiography revealed a thrombus in the hepatic artery and acute liver injury due to ischemia of the hepatic artery. The patient's blood pressure dropped on day 7 after admission, and contrast-enhanced computed tomography revealed a hematoma around the liver, multiple hepatic aneurysms, and a hyperabsorptive zone around the right hepatic aneurysm, leading to the diagnosis of intraperitoneal bleeding due to ruptured hepatic aneurysm. On the 30th day, he presented with hemoptysis, and his respiratory condition worsened; accordingly, antineutrophil cytoplasmic antibody-associated vasculitis was diagnosed based on alveolar hemorrhage and ground-glass appearance on computed tomography. The patient's symptoms improved after steroid pulse therapy and he was discharged. This case indicates that antibody-associated vasculitis rarely causes hepatic aneurysms and should be treated with caution.</p>

Journal

  • Kanzo

    Kanzo 64 (9), 437-444, 2023-09-01

    The Japan Society of Hepatology

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