Polyarteritis nodosa with ureteric stenosis

Abstract

AbstractPolyarteritis nodosa (PAN) is a primary systemic medium‐vessel vasculitides. In systemic PAN, the most frequent skin lesions are purpura, livedo, and nodules. We report a case of PAN with stenosis of the ureter. A 60‐year‐old Japanese woman had a 5‐year history of subcutaneous nodules, purpura, livedo‐like dark erythema on the bilateral lower legs, with histopathology of necrotizing vasculitis of medium‐sized arteries. Radiologically, hydronephrosis of both kidneys was found with stenosis of the ureters. She received radical nephrectomy of the right kidney and ureter and retention of ureteral stent for the left one. The removed ureter showed stenosis with prominent fibrosis of the lamina propria and muscular layer. We diagnosed the condition as systemic PAN with ureteric stenosis. Oral prednisolone exerted a good therapeutic effect. There have been reported 16 cases of systemic PAN with ureteric stenosis, including our case. Ureteric stenosis is one of the important manifestations of systemic PAN.