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WEGENER’S GRANULOMATOSIS COMPLICATED WITH APHTHOID COLITIS

A 58‐year‐old man was admitted with upper abdominal pain and high fever. There was no abnormality on chest X‐ray, abdominal ultrasonography, abdominal CT and upper gastrointestinal endoscopy. Antineutrophil cytoplasmic antibodies (C‐ANCA) titers were high and a chest CT scan depicted multiple nodules in the bilateral lungs. A diagnosis of Wegener’s granulomatosis was therefore made. Three weeks after admission, diarrhea and bloody stool developed. Colonoscopy revealed many aphthoid lesions surrounded by redness in the entire colon. Although the biopsy from aphtha did not show vasculitis or granuloma, the aphthoid lesions were suspected as a complication of Wegener’s granulomatosis. As a result of predonisolone medication (60 mg/day), the plasma C‐reactive protein (CRP) and high fever improved promptly. In conclusion, although colonic involvement in a patient with Wegener’s granulomatosis is extremely rare, it is important to keep in mind that colonic lesions might be due to vasculitis in ANCA‐positive disease, such as Wegener’s granulomatosis.