A case of significant gastrointestinal involvement in granulomatosis with polyangiitis

Granulomatosis with polyangiitis (GPA) is a rare, autoimmune condition usually presenting with pulmonary and renal involvement. There are not many reports of gastrointestinal involvement and even fewer cases of disseminated disease. We present a case of biopsy-proven, active gastrointestinal GPA throughout the stomach, small intestine and colon. Patients may present with diffuse abdominal pain, making the diagnosis difficult. We suggest that unidentified or inadequately managed gastrointestinal involvement in GPA is a potentially serious condition. This disease manifestation must be maintained in the differential in at-risk patients with gastrointestinal symptoms, and appropriate imaging should be considered when clinical suspicion warrants.