Ruptured left gastric and dilated right gastroepiploic artery aneurysms during corticosteroid pulse therapy in severe nephrotic syndrome.

We describe a case of a ruptured left gastric artery aneurysm during corticosteroid pulse therapy in a patient with severe nephrotic syndrome, followed by a dilated right gastroepiploic artery aneurysm within 2 months. Each aneurysm was treated by coil embolization. Other multi-artery aneurysms were identified and subsequently thrombosed or resolved. Multiple arterial aneurysms and rapid arterial transformations indicated segmental arterial mediolysis. Although corticosteroid therapy improves arteritis, it may cause rupture or dilatation of visceral artery aneurysms associated with segmental arterial mediolysis, and short-interval follow-up should be considered.