A case of fatal gastrointestinal hemorrhage in granulomatosis with polyangiitis

Although granulomatosis with polyangiitis (GPA) can affect any organ, gastrointestinal (GI) involvement is uncommon. Moreover, death from massive GI hemorrhage is a rare entity, with few cases described in the literature. In our report, we present a case of a patient with GPA who developed massive ulcerative bleeding, which ultimately proved fatal. Given the paucity of reports available, the significant potential for morbidity, and the fact that concurrent immunosuppressive therapy may themselves exacerbate the risk of bleeding, we reviewed 49 case reports of patients with GPA and GI involvement from 1982 to June 2016 in an attempt to shed light on a little seen sequelae that warrants a high index of suspicion.