ANCA-associated vasculitis in a patient with enteropathic spondylarthritis: a case report and literature review

Coexistence of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and inflammatory bowel disease (IBD) is rare (Sy et al. in Semin Arthritis Rheum 45:475–482, 2016). Nevertheless, we present a case of an AAV in a 53-year-old female with enteropathic spondylarthritis previously tr...

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Bibliographic Details
Published in:Clinical rheumatology 2021-08, Vol.40 (8), p.3351-3355
Main Authors: Guimarães, Francisca, Santos-Faria, Daniela, Azevedo, Soraia, Ramos Rodrigues, Joana, Leite Silva, Joana, Esperança-Almeida, Diogo, Ribeiro, Bárbara, Vaz, Raquel, Teixeira, Filipa, Tavares-Costa, José, Afonso, Carmo, Peixoto, Daniela
Format: Article
Language:English
Subjects:
Antineutrophil cytoplasmic antibodies
Arthritis
Case Based Review
Case reports
Coexistence
Differential diagnosis
Inflammatory bowel disease
Inflammatory bowel diseases
Literature reviews
Medicine
Medicine & Public Health
Patients
Rheumatology
Tumor necrosis factor-α
Vasculitis
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Summary:Coexistence of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and inflammatory bowel disease (IBD) is rare (Sy et al. in Semin Arthritis Rheum 45:475–482, 2016). Nevertheless, we present a case of an AAV in a 53-year-old female with enteropathic spondylarthritis previously treated with tumor necrosis factor α inhibitors (TNFi). Management of vasculitis in a patient with IBD may be problematic due to the difficulty in distinguishing if the vasculitis is an extraintestinal manifestation of the IBD or a new coexistent entity. Moreover, in our report, the previous treatment with TNFi is a possible confounding factor due to the paradoxical effects induced by TNFi, including vasculitis (Ramos-Casals et al. in Curr Rheumatol Rep 10:442–448, 2008). The reported case alerts to the complexity in the management of patients with enteropathic spondylarthritis and vasculitis, as well as discusses the diversity of differential diagnosis in this particular clinical scenario.
ISSN:0770-3198
1434-9949
DOI:10.1007/s10067-021-05612-y