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Pelvic vasculitis - need helpFrom: Peter V. Weston, M.D. (weston@ICSI.Net)Fri Dec 8 15:12:53 1995
Hi folks, I have been asked by a rheumatologist to consult on a 39 year old patient who has been suffering from chronic lower abdominal pain for many years, unresponsive to NSAIDs and Oral Contraceptives. Recent TVS suggested a 5 cm pelivic mass. She has undergone 3 laparoscopies and recently underwent a laparotomy. The findings were dense pelvic adhesions around both ovaries and dense adhesions attaching the sigmoid to the lateral pelvic side wall. No masses were seen, no endometriosis was seen but the cul de sac contained several red areas. Bipsies of these areas showed a florid vasculitis with WBCs in vascular walls. The slides were presented at a local meeting of pathologists and the best diagnosis that they could come up with was Leucocytoclastic vasculitis - non specific pattern. For what it is worth the patient is tall, has arachnoidactaly and is myopic - suggestive of Marfan syndrome. I would appreciate suggestions on further workup and management. I have not yet seen the patient. Thanks Peter -- Peter V. Weston, M.D. Private Practice, Gynecology, San Antonio. weston@icsi.net
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