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Vaskulitiden im Grenzbereich von Leber- und Darmerkrankungen

Vasculitides in the borderline of liver and intestinal diseases

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Die Gastroenterologie 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 ANCA(antineutrophile zytoplasmatische Antikörper)-Vaskulitis bedürfen einer konsequenten immunsuppressiven Behandlung, und infektiöse Komplikationen wie eine CMV(Zytomegalievirus)-Kolitis müssen von vaskulitischen Manifestationen unterschieden werden.

Einigen Vaskulitisformen (kryoglobulinämische Vaskulitis, Polyarteriitis nodosa) kann eine Hepatitis-B/-C-Virus-Infektion zugrunde liegen. Patienten mit kryoglobulinämischer Vaskulitis können von einer Kombinationstherapie aus antiviraler Behandlung und B‑Zell-Depletion profitieren.

Abstract

Background

Vasculitides can involve several different organ systems. Gastrointestinal manifestations regularly occur in some systemic vasculitides and require specific treatment. Hepatitis B and C virus infections can trigger certain forms of vasculitis.

Objective

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

Conclusion

Gastrointestinal lesions as a result of antineutrophil cytoplasmic antibody (ANCA) vasculitis particularly require a consistent immunosuppressive treatment and infectious complications, such as cytomegalovirus (CMV) colitis need to be distinguished from vasculitic manifestations. Some forms of vasculitis (cryoglobulinemic vasculitis and polyarteritis nodosa) can be caused by a hepatitis B or C virus infection. Patients with cryoglobulinemic vasculitis can benefit from a combination treatment consisting of antiviral treatment and B‑cell depletion.

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Authors and Affiliations

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

    A. Schönfeld &  O. Witzke

  2. Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    J. Rashidi-Alavijeh

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

    B. Wilde

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  1. A. Schönfeld
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Correspondence to O. Witzke.

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Interessenkonflikt

A. Schönfeld, J. Rashidi-Alavijeh, B. Wilde und O. Witzke geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Martina Müller-Schilling, Regensburg

Stefan Zeuzem, Frankfurt am Main

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Schönfeld, A., Rashidi-Alavijeh, J., Wilde, B. et al. Vaskulitiden im Grenzbereich von Leber- und Darmerkrankungen. Gastroenterologie 17, 308–317 (2022). https://doi.org/10.1007/s11377-022-00641-8

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  • DOI: https://doi.org/10.1007/s11377-022-00641-8

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