Wegener ' sGranulomatosis with Relapsed Gastric Ulcers : A Case Report Bleeding of

We treated a 55-year-old male patient with Wegener's granulomatosis (WG) asseciated with frequent gastric bleeding from multiple ulcerative lesiens. Only a few cases of frequent hemorrhaging of peptic ulcers associated with WG have been reported. In our case, a gastric biopsy showed mononuclear cell infi1tratipn in the submucosal areeq without granulomas or vasculitis. An endoscopic, maneuver, as well as administration of immunosuppressive. agents, combined with an H2 receptor antagonist and proton pump inhibitor successfu11y eliminated the gastrointestinal bleeding. In this case, proof that the gastrointestihal ihvolvement was pathologically related to WG could not be demonstrated because neithbr granulomas nor vasculitis were observed in the insuMcient biopsy specimen of the stomach. It is also possible that the urernic state and cytetoxic agents worsened the gastrointestinal involvepaent. However, immunosuppressive therapy combined with routine 4ntiulcer trehtment was very effective in repairing the ulcerative lesions. The gastrointestinal involvement was considered a possible complication ef the WG.