A Case Report of Allergic Granulomatous Angiitis with the
Multiple Intestinal Perforation

Nobuhiko Taniai, Masahiko Onda, Takashi Tajiri, Kiyonori Furukawa, Hideaki Takasaki, Yoshio Ogawa, and Zenya Naitou^*

First Department of Surgery and Pathology^*, Nippon Medical School

A case of allergic granulomatous angiitis (AGA) complicated with multiple perforation of the ileum is described. A 40-year-old woman had suffered from bronchial asthma for ten years, and had been treated for 2 years with steroid hormones under a diagnosis of AGA. She was admitted to our hospital complaining of right lower abdominal pain. Laboratory tests highlighted an increase in WBC (9,600/mm³) and CRP (11.3ng/dl), but eosinophil count (0.0%) and IgE (240U/ml) were at normal levels. She was diagnosed as having gastrointestinal perforation by abdominal physical findings and underwent an emergency operation. Three ileal perforations, which located 30, 33, and 60 cm from terminal ileum, were found intraoperatively and an ileotomy was carried out. Only 19 cases of AGA complicated with the intestinal perforations have ever been reported in Japan. Almost all cases were in the active stage on laboratory data at perforation. However, this is a rare case, because it perforated at the non-active stage.

Key words
allergic granulomatous angiitis, intestinal perforation

Reprint requests
Nobuhiko Taniai First Department of Surgery, Nippon Medical School 1-1-5 Sendagi, Bunkyou-ku, Tokyo, 113-8603 JAPAN

Accepted
June 22, 1999

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