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Vaskulitiden mit gastrointestinalen Manifestationen

Vasculitides with gastrointestinal manifestations

  • Schwerpunkt
  • Published:
Der Gastroenterologe Aims and scope

Zusammenfassung

Hintergrund

Vaskulitiden können zahlreiche, unterschiedliche Organsysteme betreffen. Gastrointestinale Manifestationen kommen regelhaft bei Vaskulitiden vor und müssen spezifisch behandelt werden. Hepatitis-B/-C-Virus-Infektionen können bestimmte Vaskulitisformen auslösen.

Ziel

Diese Übersichtarbeit beleuchtet die interdisziplinären Herausforderungen in der Diagnose und Therapie von Vaskulitiden.

Schlussfolgerung

Insbesondere gastrointestinale Läsionen infolge einer Vaskulitis durch antineutrophile zytoplasmatische Antikörper (ANCA) bedürfen einer aggressiven immunsuppressiven Behandlung und infektiöse Komplikationen, wie eine Zytomegalievirus(CMV)-Kolitis, müssen von vaskulitischen Manifestationen unterschieden werden. Einigen Vaskulitisformen (kryoglobulinämische Vaskulitis, Polyarteriitis nodosa) kann eine Infektion mit Hepatitis-B-Virus (HBV) oder Hepatitis-C-Virus (HCV) zugrunde liegen. Patienten mit kryoglobulinämischer Vaskulitis profitieren möglicherweise von einer Kombinationstherapie aus antiviraler Behandlung und B‑Zell-Depletion.

Abstract

Background

Vasculitides can affect several different organ systems. Gastrointestinal involvement is quite common in some systemic types of vasculitis and requires modified treatment. Moreover, hepatitis B/C infections can trigger the development of specific vasculitides.

Aim

This review highlights and discusses the interdisciplinary challenges of diagnosis and treatment of vasculitis.

Conclusion

Intestinal lesions in patients with antineutrophil cytoplasmic antibodies (ANCA) vasculitis require immunosuppressive treatment and infectious complications such as cytomegalovirus (CMV) colitis must be distinguished from relapse with intestinal vasculitic lesions. Cryoglobulinemic vasculitis can be triggered by hepatitis C virus (HCV) infection and should be treated with antiviral therapy; B cell depletion might be considered to achieve remission of vasculitis.

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Authors and Affiliations

  1. Klinik für Nephrologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    B. Wilde

  2. Klinik für Infektiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    O. Witzke

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Correspondence to O. Witzke.

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Interessenkonflikt

B. Wilde und O. Witzke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Redaktion

G. Gerken, Essen

S. Zeuzem, Frankfurt am Main

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Wilde, B., Witzke, O. Vaskulitiden mit gastrointestinalen Manifestationen . Gastroenterologe 12, 496–501 (2017). https://doi.org/10.1007/s11377-017-0206-9

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