Splenic rupture as the presenting manifestation of vasculitis

McCain, Michelle, Quinet, Robert, Davis, William, Serebro, Leonard, Zakem, Jerald, Nair, Priya and Ishaq, Saliha (2002) Splenic rupture as the presenting manifestation of vasculitis. Seminars in Arthritis and Rheumatism, 31 5: 311-316. doi:10.1053/sarh.2002.30636

Author McCain, Michelle
Quinet, Robert
Davis, William
Serebro, Leonard
Zakem, Jerald
Nair, Priya
Ishaq, Saliha
Title Splenic rupture as the presenting manifestation of vasculitis
Journal name Seminars in Arthritis and Rheumatism   Check publisher's open access policy
ISSN 0049-0172
Publication date 2002-04
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1053/sarh.2002.30636
Volume 31
Issue 5
Start page 311
End page 316
Total pages 6
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Language eng
Formatted abstract
Background: Although underreported, histologic splenic involvement in Wegener's granulomatosis (WG) is not unusual. Splenic rupture in association with WG, however, is rare. Only 2 cases of nontraumatic splenic rupture have been reported as the initial feature of WG. Isolated cases of splenic rupture also have been noted in rheumatoid arthritis, systemic lupus erythematosus, and polyarteritis nodosa.

Objective: To report the third case of splenic rupture as the presenting feature of WG and review the literature concerning splenic rupture in other rheumatologic diseases to better delineate a mechanism for this rare occurrence.

Methods: Descriptive case report of 1 patient with WG with antecedent splenic rupture and a review of the relevant literature using a MEDLINE search from 1950 to 2001.

Results: Our patient presented with symptoms and signs of WG 2 weeks after nontraumatic splenic rupture. Two similar cases have been reported: one showed splenic vasculitis histologically and the other only a neutrophilic infiltration at the site of the splenic tear and subcapsular zone after surgery. Although splenic capsular and pulp hemorrhage alone without signs of vasculitis were noted in our patient, no other cause (ie, hematologic, infectious, neoplastic, or otherwise) for splenic rupture was found.

Conclusions and Relevance: As in the 2 reported cases, WG may have been responsible for splenic rupture in our patient. Regardless, early evaluation for connective tissue disease in a patient with spontaneous splenic rupture without apparent cause merits consideration, as it may affect patient follow-up and treatment.
Keyword Wegener's granulomatosis
Splenic rupture
Splenic infarction
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 09:57:55 EST