Aortic Aneurysm as a Complication of Granulomatosis with Polyangiitis Successfully Treated with Prednisolone and Cyclophosphamide: A Case Report and Review of the Literature

Table 1

Case of aortic involvement in granulomatosis with polyangiitis.

Case	Age/gender (years)	Affected site	Antibodies	Duration of complaint	Treatment	Rupture	Outcome
1 [1]	38/M	TAA	Anti-neutrophil cytoplasmic antibodies × 128	NS	Surgery (J-graft) + PSL 15 mg/day	Yes	Good
2 [13]	51/M	Distal part of aorta (3.8 cm)	Anti-proteinase-3 antibodies > 530 kU/L	2 months	Steroid pulse + PSL 1 mg/kg + CY 2 mg/kg/day	No	Good
3 [14]	45/M	Aorta, extending to the right iliac artery	ANCA + NS	5 days	Right ureterolysis + immunosuppressive therapy	No	Good
4 [15]	33/M	AAA	Antiproteinase-3 (>1/10)	3 weeks	IJV graft + PSL + CY	No	Good
5 [16]	42/M	AAA	Antiproteinase-3 157 AU/l	1 month	Aortoiliac graft and high-dose PSL + CY 2 mg/kg/day	No	Good
6 [17]	63/M	AAA (5.4 cm)	p-ANCA 1/80 and MPO 28 U/l	2 months	Surgery + PSL 1 mg/kg + CY 2 mg/kg	No	Good
7 [18]	50/F	TAA	p-ANCA (1 : 320) antimyeloperoxidase 440 U/ml	2 months	PSL + CY	Yes	Death
8 [19]	43/M	Infrarenal aorta (3.1 × 3.5 cm)	NS	1 week	PSL + surgery	No	Good
9 [20]	29/M	Branches of hepatic and renal arteries	Anti-PR3 ANCA 15 IU/mL	NS	Coil embolization + steroid pulse + PSL 60 mg + MMF 2.5 g	No	Good
10 [21]	34/M	Anterior choroidal artery	PR3 ANCA 457 EU	1 year	Clipping + steroid pulse + PSL 40 mg + CY	Yes	Good
11 [22]	67/M	Superior pancreaticoduodenal artery	C-ANCA 1 : 512 PR3 ANCA 88 IU/L	11 months	IVCY (0.7 g/m2) every 3 weeks + steroid pulse + PSL 1 mg/kg/day	Yes	Death
12 [23]	58/F	Subclavian aneurysm	P-ANCA 68 units	2 months	PSL 1 mg/kg + CY 2 mg/kg + stent graft	No	Good
13 [24]	56/M	Left gastric artery	C-ANCA positive	1 month	None	Yes	Death
14 [25]	55/M	Hepatic artery	C-ANCA 1 : 80	3 weeks	mPSL + CY	Yes	Death
15 [26]	24/M	Bilateral renal artery	NS	6 weeks	PSL 30 mg + CY 150 mg/day	Yes	Good
16 [27]	59/M	Aorta	C-ANCA 158 SLI units	9 months	Coronary artery bypass + steroid pulse + PSL + CY 3 mg/kg + plasmapheresis	No	Good
17 [28]	35/M	Hepatic, renal, splanchnic	C-ANCA positive	6 weeks	Steroid pulse + PSL + IVCY 750 mg	Yes	Good
18 [29]	30/M	Renal artery	NS	1 month	PSL 1 mg/kg/day and CY 2 mg/kg/day	No	Good
19 [30]	53/F	Renal artery	NS	20 days	PSL 1 mg/kg/day + CY 2 mg/kg/day + hemodialysis	No	Good
20 [30]	79/M	TAA	PR3-ANCA 1180 EU	8 months	Steroid pulse PSL 60 mg + IVCY 300 mg	Yes	Death
Present case	58/M	AAA	PR3 ANCA 187 IU/ml	2 weeks	Steroid pulse + PSL 55 mg + IVCY 500 mg	No	Good

TAA: thoracic aortic aneurysm; AAA: abdominal aortic aneurysm; F: female; M: male; NS: not stated; PSL: prednisolone; CY: cyclophosphamide; mPSL: methylprednisolone; MMF: mycophenolate mofetil; IVCY: intravenous cyclophosphamide; IJV: internal jugular vein.