Wegener's granulomatosis presenting as an abdominal aortic aneurysm: a case report

Abstract

Introduction: Aortic aneurysm is not common in young patient. When a young patient presents with abdominal aortic aneurysm, there may be an underlying cause.

Case presentation: Here, we describe a case of a 33-year-old gentleman who presented with flu like illness, chest and abdominal pains following a tooth extraction. A chest X-ray and subsequent computerised tomogram of the chest and abdomen demonstrated lung nodules and an abdominal aortic aneurysm. The aneurysm was repaired and his serology was positive for Wegener's granulomatosis. A nasal mucosal biopsy confirmed WG. He was treated with oral steroids and cyclophosphamide. His graft leaked and had to be replaced with a synthetic graft. Two months after his re-operation, he remains well.

Conclusion: Whenever a young patient presents with an abdominal aortic aneurysm, an underlying connective disease should be excluded because early steroid/immunosuppressive treatment may prevent the development of further aneurysms.

Figure 1

(A) CT scan of abdomen showing a localised abdominal aortic aneurysm. (B) CT scan of the chest showing lung nodules at the left lower lobe.

Figure 2

(A) Haematoxylin and eosin (H&E) staining (× 10) of nasal biopsy showing mucosal ulceration (B) H&E (× 40) showing extensive inflammatory reaction in the corium, with hyperplastic rete processes, and giant cells.