Extended colonic ulcerations in a patient with microscopic polyangiitis.

M icroscopic polyangiitis is a necrotising vasculitis primarily affecting small vessels, with few or no immune deposits. Patients are characterised by positive antineutrophil cytoplasmic antibodies (ANCA), mainly perinuclear pattern. The spectrum of clinical manifestations is broad, including the kidney, musculoskeletal system, lung, gastrointestinal tract, skin, ear, nose, and throat, and neurological system. Although gastrointestinal disease is noted in half of the patients, the presentation is usually mild. Here, we report a patient with microscopic polyangiitis with initial presentation of extended colonic ulcerations and haemorrhage, characterised by a crypt abscess. To our knowledge, such a finding has not been reported previously.