High incidence of dieulafoy's lesions in upper gastrointestinal bleeding associated with polyarteritis - Clinical examination of patients of polyarteritis nodosa with rapidly progressive glomerulonephritis

Tadashi Ohara, Yuhsaku Kanoh, Yoshio Taguma, Hiroshi Hashimoto, Hidekazu Suzuki, Yuji Sakai, Fukuo Kondo, Jin Ichi Kameyama, Norio Tani, Keiichi Yoshino, Masaki Kitajima

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Aims: Polyarteritis nodosa (PN) has been classified into polyarteritis (PA) and microscopic polyarteritis (MA) histologically. To clarify of the characteristics of upper gastrointestinal bleeding lesions in PN, we investigated the patients of PN with rapidly progressive glomerulonephritis (RPGN) presenting with upper gastrointestinal bleeding. Methodology: The subjects of this study were 21 patients of PN with RPGN (PA: 11, MA: 10) who presented with upper gastrointestinal bleeding. The bleeding lesions and their locations were examined endoscopically in the study subjects, and the relationship of the bleeding to the severity of renal failure, the necessity of hemodialysis (HD), presence/absence of H. pylori infection and the gender of the patients were analyzed. Results: The bleeding lesions were endoscopically identified as esophageal ulcers in 2 cases, gastric ulcers in 15 cases and duodenal ulcers in 4 cases, respectively. In 10 of the 15 cases with gastric ulcers, the ulcer assumed the form of Dieulafoy's lesions affecting the gastric body, and the underlying disease was PA in all the 10 cases. In the remaining 5 cases of gastric ulcers and 2 cases of esophageal ulcer with underlying MA or 4 cases of duodenal ulcers, in whom assumed the bleeding form of oozing from the marginal zone of ulcers. In all of the 4 cases of duodenal ulcers, and the 1 case with underlying PA and the other cases with MA, no correlation was found between the onset of the upper gastrointestinal bleeding and the severity of renal failure or the necessity for HD, presence of H. pylori infection, or the gender of the patients. Conclusions: Dieulafoy's lesions are the most frequent sources of upper gastrointestinal bleeding in cases of PA.

Original languageEnglish
Pages (from-to)821-825
Number of pages5
JournalHepato-Gastroenterology
Volume55
Issue number84
Publication statusPublished - 2008 May

Fingerprint

Polyarteritis Nodosa
Glomerulonephritis
Hemorrhage
Incidence
Stomach Ulcer
Duodenal Ulcer
Ulcer
Pylorus
Renal Insufficiency
Renal Dialysis
Infection
Peptic Ulcer
Stomach

Keywords

  • Dieulafoy's lesion
  • Polyareritis nodosa with rapidly progressive glomerulonephritis
  • Upper gastrointestinal bleeding

ASJC Scopus subject areas

  • Gastroenterology

Cite this

High incidence of dieulafoy's lesions in upper gastrointestinal bleeding associated with polyarteritis - Clinical examination of patients of polyarteritis nodosa with rapidly progressive glomerulonephritis. / Ohara, Tadashi; Kanoh, Yuhsaku; Taguma, Yoshio; Hashimoto, Hiroshi; Suzuki, Hidekazu; Sakai, Yuji; Kondo, Fukuo; Kameyama, Jin Ichi; Tani, Norio; Yoshino, Keiichi; Kitajima, Masaki.

In: Hepato-Gastroenterology, Vol. 55, No. 84, 05.2008, p. 821-825.

Research output: Contribution to journalArticle

Ohara, T, Kanoh, Y, Taguma, Y, Hashimoto, H, Suzuki, H, Sakai, Y, Kondo, F, Kameyama, JI, Tani, N, Yoshino, K & Kitajima, M 2008, 'High incidence of dieulafoy's lesions in upper gastrointestinal bleeding associated with polyarteritis - Clinical examination of patients of polyarteritis nodosa with rapidly progressive glomerulonephritis', Hepato-Gastroenterology, vol. 55, no. 84, pp. 821-825.
Ohara, Tadashi ; Kanoh, Yuhsaku ; Taguma, Yoshio ; Hashimoto, Hiroshi ; Suzuki, Hidekazu ; Sakai, Yuji ; Kondo, Fukuo ; Kameyama, Jin Ichi ; Tani, Norio ; Yoshino, Keiichi ; Kitajima, Masaki. / High incidence of dieulafoy's lesions in upper gastrointestinal bleeding associated with polyarteritis - Clinical examination of patients of polyarteritis nodosa with rapidly progressive glomerulonephritis. In: Hepato-Gastroenterology. 2008 ; Vol. 55, No. 84. pp. 821-825.
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abstract = "Background/Aims: Polyarteritis nodosa (PN) has been classified into polyarteritis (PA) and microscopic polyarteritis (MA) histologically. To clarify of the characteristics of upper gastrointestinal bleeding lesions in PN, we investigated the patients of PN with rapidly progressive glomerulonephritis (RPGN) presenting with upper gastrointestinal bleeding. Methodology: The subjects of this study were 21 patients of PN with RPGN (PA: 11, MA: 10) who presented with upper gastrointestinal bleeding. The bleeding lesions and their locations were examined endoscopically in the study subjects, and the relationship of the bleeding to the severity of renal failure, the necessity of hemodialysis (HD), presence/absence of H. pylori infection and the gender of the patients were analyzed. Results: The bleeding lesions were endoscopically identified as esophageal ulcers in 2 cases, gastric ulcers in 15 cases and duodenal ulcers in 4 cases, respectively. In 10 of the 15 cases with gastric ulcers, the ulcer assumed the form of Dieulafoy's lesions affecting the gastric body, and the underlying disease was PA in all the 10 cases. In the remaining 5 cases of gastric ulcers and 2 cases of esophageal ulcer with underlying MA or 4 cases of duodenal ulcers, in whom assumed the bleeding form of oozing from the marginal zone of ulcers. In all of the 4 cases of duodenal ulcers, and the 1 case with underlying PA and the other cases with MA, no correlation was found between the onset of the upper gastrointestinal bleeding and the severity of renal failure or the necessity for HD, presence of H. pylori infection, or the gender of the patients. Conclusions: Dieulafoy's lesions are the most frequent sources of upper gastrointestinal bleeding in cases of PA.",
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T1 - High incidence of dieulafoy's lesions in upper gastrointestinal bleeding associated with polyarteritis - Clinical examination of patients of polyarteritis nodosa with rapidly progressive glomerulonephritis

AU - Ohara, Tadashi

AU - Kanoh, Yuhsaku

AU - Taguma, Yoshio

AU - Hashimoto, Hiroshi

AU - Suzuki, Hidekazu

AU - Sakai, Yuji

AU - Kondo, Fukuo

AU - Kameyama, Jin Ichi

AU - Tani, Norio

AU - Yoshino, Keiichi

AU - Kitajima, Masaki

PY - 2008/5

Y1 - 2008/5

N2 - Background/Aims: Polyarteritis nodosa (PN) has been classified into polyarteritis (PA) and microscopic polyarteritis (MA) histologically. To clarify of the characteristics of upper gastrointestinal bleeding lesions in PN, we investigated the patients of PN with rapidly progressive glomerulonephritis (RPGN) presenting with upper gastrointestinal bleeding. Methodology: The subjects of this study were 21 patients of PN with RPGN (PA: 11, MA: 10) who presented with upper gastrointestinal bleeding. The bleeding lesions and their locations were examined endoscopically in the study subjects, and the relationship of the bleeding to the severity of renal failure, the necessity of hemodialysis (HD), presence/absence of H. pylori infection and the gender of the patients were analyzed. Results: The bleeding lesions were endoscopically identified as esophageal ulcers in 2 cases, gastric ulcers in 15 cases and duodenal ulcers in 4 cases, respectively. In 10 of the 15 cases with gastric ulcers, the ulcer assumed the form of Dieulafoy's lesions affecting the gastric body, and the underlying disease was PA in all the 10 cases. In the remaining 5 cases of gastric ulcers and 2 cases of esophageal ulcer with underlying MA or 4 cases of duodenal ulcers, in whom assumed the bleeding form of oozing from the marginal zone of ulcers. In all of the 4 cases of duodenal ulcers, and the 1 case with underlying PA and the other cases with MA, no correlation was found between the onset of the upper gastrointestinal bleeding and the severity of renal failure or the necessity for HD, presence of H. pylori infection, or the gender of the patients. Conclusions: Dieulafoy's lesions are the most frequent sources of upper gastrointestinal bleeding in cases of PA.

AB - Background/Aims: Polyarteritis nodosa (PN) has been classified into polyarteritis (PA) and microscopic polyarteritis (MA) histologically. To clarify of the characteristics of upper gastrointestinal bleeding lesions in PN, we investigated the patients of PN with rapidly progressive glomerulonephritis (RPGN) presenting with upper gastrointestinal bleeding. Methodology: The subjects of this study were 21 patients of PN with RPGN (PA: 11, MA: 10) who presented with upper gastrointestinal bleeding. The bleeding lesions and their locations were examined endoscopically in the study subjects, and the relationship of the bleeding to the severity of renal failure, the necessity of hemodialysis (HD), presence/absence of H. pylori infection and the gender of the patients were analyzed. Results: The bleeding lesions were endoscopically identified as esophageal ulcers in 2 cases, gastric ulcers in 15 cases and duodenal ulcers in 4 cases, respectively. In 10 of the 15 cases with gastric ulcers, the ulcer assumed the form of Dieulafoy's lesions affecting the gastric body, and the underlying disease was PA in all the 10 cases. In the remaining 5 cases of gastric ulcers and 2 cases of esophageal ulcer with underlying MA or 4 cases of duodenal ulcers, in whom assumed the bleeding form of oozing from the marginal zone of ulcers. In all of the 4 cases of duodenal ulcers, and the 1 case with underlying PA and the other cases with MA, no correlation was found between the onset of the upper gastrointestinal bleeding and the severity of renal failure or the necessity for HD, presence of H. pylori infection, or the gender of the patients. Conclusions: Dieulafoy's lesions are the most frequent sources of upper gastrointestinal bleeding in cases of PA.

KW - Dieulafoy's lesion

KW - Polyareritis nodosa with rapidly progressive glomerulonephritis

KW - Upper gastrointestinal bleeding

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