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Abdominal computed tomography indicated diffuse wall thickening of the entire colon. A colonoscopy revealed extensive edema, several ulcers, and mucosal friability, resulting in the diagnosis of ulcerative colitis. Blood tests revealed hypoalbuminemia, increased inflammatory marker levels, and high proteinase3 anti\u2010neutrophil cytoplasmic antibody (PR3\u2010ANCA) levels. Urinalysis showed hematuria and casts, raising the suspicion of concurrent vasculitis syndrome. Esophagogastroduodenoscopy revealed multiple punched\u2010out ulcers in the esophagus. Granulomatosis with polyangiitis with gastrointestinal involvement was diagnosed combined with the positive PR3\u2010ANCA results and skin and renal involvement. Steroid therapy was initiated, leading to the rapid improvement of diarrhea, purpura, and esophageal ulcers. While high PR3\u2010ANCA levels are occasionally observed in ulcerative colitis, esophageal ulcers in patients with granulomatosis with polyangiitis\u00a0often result in poor symptoms. Thus, esophagogastroduodenoscopy should be considered in patients with high PR3\u2010ANCA levels, even in the absence of upper gastrointestinal symptoms.<\/jats:p>","DOI":"10.1002\/deo2.70089","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T22:52:45Z","timestamp":1741647165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple esophageal ulcers in a pediatric case of granulomatosis with polyangiitis: A case report"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9271-4725","authenticated-orcid":false,"given":"Yuki","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Pediatrics Gunma University Graduate School of Medicine  Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ishige","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Gunma University 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