Symptom Of Polyarteritis Nodosa Research Articles

Polyarteritis nodosa: An unusual cause of life-threatening intra-abdominal bleeding

Intra-abdominal arterial bleeding is a life-threatening condition, warranting immediate causal therapy. Polyarteritis nodosa is a rare type of necrotizing vasculitis that affects medium-sized arteries. We present a patient with severe arterial bleeding as the first symptom of polyarteritis nodosa. Because the bleeding took place intra-abdominal instead of gastro-intestinal, there was no macroscopic blood loss. She was successfully treated with endovascular coil embolization during angiography.

A Rare Clinical Presentation of Vasculitis as a Gastrointestinal Bleed

Introduction: Polyarteritis nodosa (PAN) is a vasculitis of medium and small-sized arteries, primarily occurring in the kidneys, and nervous system. Case: We present a 70-year-old man with two episodes of hematochezia in the last 24 hours. Patient was resuscitated with intravenous (IV) fluids, and 17 units of packed red blood cells (RBC) over the hospital course. Tagged RBC scan demonstrated evidence of active bleeding in the small bowel and the ascending colon. Angiography showed multiple pseudoaneurysms in branches of the left gastric, splenic and superior mesenteric arteries (SMA). Gastroenterology performed an upper gastrointestinal (GI) endoscopy, single balloon enteroscopy, and colonoscopy, which did not yield a source of bleed, yet the hematocrit continue to plummet. An alternate diagnosis of PAN was considered. Rheumatology suggested IV steroids, after which the patient's hematocrit stabilized with complete resolution of symptoms. Further workup demonstrated low complement supporting the diagnosis of PAN. Discussion: PAN typically presents with an array of systemic symptoms, however, a subset of patients have mesenteric arterial involvement with no clinical evidence of extraintestinal symptoms. One study demonstrated that angiographic diagnosis of PAN has a sensitivity of 89% and a specificity of 90%. In patients with severe PAN, characterized by GI bleed, IV steroids should be initiated for three days followed by other immunosuppressant therapy. In this case the patient presented with an acute lower GI bleed and no other clinical symptoms of PAN. Upon failed attempts to visualize a source of GI bleed, a mesenteric angiography demonstrated multiple pseudoaneurysms. Persistent lower GI bleed only subsided with IV steroids, resulting in an interdisciplinary consensus that his GI bleed was likely secondary to PAN. In conclusion this case demonstrates that systemic vasculitis can present with serious GI hemorrhage, even in the absence of other signs and symptoms of PAN. Mesenteric angiography clearly demonstrated that vasculitic lesions can develop and resolve rapidly with prompt, aggressive management.Figure

Necrosis of the tongue as first symptom of Polyarteritis Nodosa (PAN): unusual presentation of a rare disease in children

Polyarteritis or panarteritis nodosa (PAN) is a necrotizing, focal segmental vasculitis that affects predominantly medium-sized arteries in many different organ systems. It is extremely rare in childhood. Involvement of the oral mucosa at diagnosis is uncommon in PAN. Here, we report a case of a pediatric patient with tongue necrosis.

A case of polyarteritis nodosa complicated by rectal cancer.

Solid cancers are rarely complicated by the occurrence of polyarteritis nodosa (PN), and most cases diagnosed as PN are, in fact, cases of paraneoplastic vasculitis. Paraneoplastic vasculitis is usually resolved after tumor removal. We present a rare case of a 69-year-old man with PN complicated by rectal cancer, without the occurrence of paraneoplastic vasculitis. Microscopic examination of the resected cancer lesion revealed inflammation of some arteries and neutrophil and lymphocyte infiltration, fibrin deposition, stenosis, and vasodilatation of capillaries caused by congestion in the submucosal layer. It was unclear how these findings exerted influence on the rectal cancer. Although the symptoms of PN did not improve after the patient's tumor was removed surgically, the symptoms improved rapidly after oral treatment with prednisolone and cyclophosphamide.

Paciente con hiperaminotransferasemia y mononeuritis múltiple

We present the case of a 57-year-old man with mononeuritis multiplex and high transaminase levels. After investigations, the patient was diagnosed with acute hepatitis B infection and polyarteritis nodosa (PAN). The symptoms of PAN are nonspecific. Nervous system involvement in the form of mononeuritis multiplex can be one of the forms of presentation. PAN is one of the extrahepatic manifestations of hepatitis B, but since the introduction of the hepatitis B vaccine, its incidence has markedly declined. After 1 year of follow-up, the patient is asymptomatic following treatment with antiviral drugs and steroids.

Polyarteritis nodosa presenting as pancytopenia: case report and review of the literature

Polyarteritis nodosa (PAN) is not commonly associated with hematologic abnormalities. We report the first case of pancytopenia as the presenting symptom of PAN. There was no associated malignancy or reactive hemophagocytic syndrome (RHS) to explain the findings. The patient, after successful treatment of PAN, subsequently developed RHS a few years later. He is the fourth reported case of RHS in a patient with PAN. In addition to describing the patient's presentation and clinical course, a systematic review of the literature was performed examining the association between hematologic conditions, including RHS, and PAN.

Rapidly progressive hearing loss as a symptom of polyarteritis nodosa

The hearing loss that occurs in polyarteritis nodosa is due largely to middle ear effusion but usually appears as a mixed type. Pure perceptive hearing loss is rare; only two cases have been reported previously in which sensorineural hearing loss was the initial sign of the disease. A case of profound, rapidly deteriorating perceptive hearing loss in which the etiology was not clear is described. One year after the onset of hearing loss, other manifestations of polyarteritis nodosa led to the diagnosis.