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Case Reports in Surgery
Volume 2018, Article ID 6145903, 4 pages
https://doi.org/10.1155/2018/6145903
Case Report

Granulomatosis with Polyangiitis Localized in the Greater Omentum

1Department of Gastroenterological Surgery, Mitsui Memorial Hospital, Tokyo, Japan
2Department of Pathology, Mitsui Memorial Hospital, Tokyo, Japan

Correspondence should be addressed to Ryuji Komine; moc.liamg@kr.dem.arod

Received 18 December 2017; Accepted 8 February 2018; Published 28 February 2018

Academic Editor: Tahsin Colak

Copyright © 2018 Ryuji Komine et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Granulomatosis with polyangiitis (GPA) is known as anti-neutrophil cytoplasmic antibody- (ANCA-) associated small vessel vasculitis and typically manifests as pulmonary-renal syndrome, but the disease is not limited to pulmonary or renal systems. The inflammation can involve whole body organs. In addition, the ANCA titer does not always become positive. Here, we describe the case of a 91-year-old man who presented with umbilical pain and fever of unknown origin. Only the increased computed tomography value of the greater omentum suggested intra-abdominal inflammation; however, serological examinations, including the ANCA level, could not reveal the focus or cause of symptoms. Finally, the histopathological examination of specimens surgically excised from the greater omentum demonstrated GPA limited to the greater omentum. This report reminds physicians to consider GPA in the differential diagnosis of acute abdominal pain or fever of unknown origin.