To improve the understanding of systemic vasculitis in the elderly.

Retrospectively analyzed the clinical data of 89 elderly patients with systemic vasculitis (SV) from January 2006 to January 2017 in our hospital. Among them we focused on the data of two patients with intestinal obstruction, including the clinical features, diagnosis, treatment process and prognosis.

SV had various clinical manifestations. Among them, fever was a common symptom, and other nonspecific symptoms were often accompanied, such as fatigue, cough, dizziness, chest pain, and insomnia. All organ dysfunction can be involved, especially kidney and lung. In most patients, ESR or CRP were usually raise. Among them 2 patients complicated with intestinal obstruction, 1 was diagnosed as allergic vasculitis, who was treated with glucocorticoid and mycophenolate mofetil and was relieved. The other patient underwent surgery for intestinal obstruction and misdiagnosed as "ischemic intestinal disease". One year later, the patient developed progressive renal impairment, and the cytoplasmic and perinuclear anti-neutrophil cytoplasmic antibodies were strongly positive. The diagnosis was corrected to "microscopic vasculitis". Due to the patient's advanced age and without receiving hormone therapy, the patients suffered from acute renal failure and quickly died.

Elderly patients with intestinal obstruction as the initial symptom or complication need to be excluded for systemic vasculitis, so as to avoid misdiagnosis.