A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

Golovine, S; Parikh, Sameer; Lu, Lee

doi:10.1007/s11606-008-0683-0

Cited by 17 publications

(14 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are few case reports of PAN presenting as PVD and limb vessel involvement. [1234] Similar to our case, the case reported by De Golovine et al . [1] had lower limb ischemia and bilateral femoral artery involvement.…”

Section: Discussionsupporting

confidence: 89%

Polyarteritis nodosa presenting as peripheral vascular disease and acute limb ischemia

Shukla

Aggarwal

2017

Journal of Postgraduate Medicine

View full text Add to dashboard Cite

Acute limb ischemia and peripheral vascular disease (PVD) are unusual presentations of polyarteritis nodosa (PAN). Here, we present a case with PVD of both lower limbs leading to foot claudication. Digital subtraction angiography showed narrowing, irregularity, and occlusion of both lower limb arteries with no involvement of the abdomen visceral arteries. Based on significant weight loss, diastolic blood pressure >90 mmHg, myalgia, testicular pain, and angiographic abnormalities in medium-sized arteries, he was diagnosed as having PAN. He was treated with corticosteroid and bolus intravenous cyclophosphamide following which he had prompt and near-complete recovery of the symptoms without any tissue loss.

show abstract

Section: Discussionsupporting

confidence: 89%

Polyarteritis nodosa presenting as peripheral vascular disease and acute limb ischemia

Shukla

Aggarwal

2017

Journal of Postgraduate Medicine

View full text Add to dashboard Cite

show abstract

“…To date not many cases with PAN associated with peripheral vascular disease have been published. Although not typical, bilateral limb claudication and symmetrical peripheral gangrene were described as a presenting feature of PAN in some patients (31,32,33,34). These rare cases outline the variable and unexpected clinical picture of PAN.…”

Section: Polyarteritis Nodosamentioning

confidence: 96%

Vasculitides as a rare cause of intermittent claudication

Celecova¹,

Krahulec²,

D³

et al. 2013

BLL

View full text Add to dashboard Cite

Intermittent claudication of the lower extremities is a common symptom described in older patients with atherosclerotic peripheral arterial disease. Peripheral arterial disease due to atherosclerosis is known to be associated with a higher risk of myocardial infarction, stroke and all-cause mortality. However, if intermittent claudication appears in a younger group of patients or older patients in absence of traditional risk factors for atherosclerosis such as smoking, dyslipidemia, arterial hypertension and diabetes mellitus other causes than atherosclerosis must be considered. These conditions include vasculitides, fi bromuscular dysplasia, cystic adventitial disease, excentric vascular compression by tumor, popliteal artery entrapment syndrome, trauma or dissection. Vasculitides present a heterogenous group of disorders characterized by infl ammatory destruction of blood vessels. Although often not a leading symptom intermittent claudication could be a part of a clinical picture in giant-cell arteritis, Takayasu´s arteritis, Buerger´s disease, polyarteritis nodosa or Behçet disease. Limb claudication is usually of rapid onset, progressive and bilateral. Each of the mentioned vasculitides is specifi c in ethiology and clinical manifestation with a variable prognosis for the patient. Increased awareness of the presence of different causes of limb claudication and their early diagnosis with a prompt initiation of appropriate treatment may help to avoid clinical progression that can lead to vascular surgery or even limb loss (Ref. 37). Full Text in PDF www.elis.sk.

show abstract

“…The cerebral angiography usually reveals aneurysms and stenosis/occlusion of the carotid arteries in the intracranial segment (28,29). Segmental artery occlusion/stenosis, with a predilection for branching and bifurcations, is characteristic (29). The imaging aspects that sustain the PaN diagnosis in our case are the stenosis of the left VA, the wide fusiform aneurysms that involves the bifurcation of the Ba and the saccular aneurysm of the left internal carotid artery, 7 mm in diameter.…”

Section: Discussionmentioning

confidence: 52%

“…Visceral arteries involvement is predominant, together with limb and aortic vessels. The cerebral angiography usually reveals aneurysms and stenosis/occlusion of the carotid arteries in the intracranial segment (28,29). Segmental artery occlusion/stenosis, with a predilection for branching and bifurcations, is characteristic (29).…”

Section: Discussionmentioning

confidence: 99%

Cerebellar and brainstem infarction secondary to basilar artery dolichoectasia

Moţăţăianu¹,

Bărcuțean²,

Maier³

et al. 2019

Ro J Neurol.

View full text Add to dashboard Cite

Vertebrobasilar dolichoectasia (VBD) is a rare condition characterized by a significant dilation, elongation and tortuosity of the arteries emerging from the vertebrobasilar system. In this study, we report a 57-year-old male, with medical history of recurrent migraines and right peroneal nerve palsy, which presents the sudden onset of clinical signs of brainstem and cerebellar stroke. The brain CT scan revealed an inhomogeneous, hyperdense prepontine lesion, situated in the area of basilar artery (BA) projection. The cerebral angiography showed in the V4 segment of the left vertebral artery (VA) a focal, concentric stenosis of 70%, followed by a fusiform dilation extended to the BA bifurcation, a saccular aneurysmal dilation in the communicant segment of the internal carotid artery and tortuous trajectory of the abdominal and thoracic aorta, including the supra-aortic vessels. The brain MRI revealed a bulbopontin and left cerebellum infarction. Patient developed at 48 hours after hospitalization livedo reticularis at the level of the right thoracic wall and thighs. The nerve conduction studies revealed mononeuritis multiplex. The vascular anomaly that was identified in the presented case respects the criteria for a VBD, however the involvement of the aorta with the presence of tortuosities, the simultaneous presence of the internal carotid artery aneurysm, together with the presence of the mononeuritis multiplex and the skin condition (livedo reticularis) suggest the possibility of coexistence of a systemic vasculitis, possible polyarteritis nodosa.

show abstract

A Case of Polyarteritis Nodosa Presenting Initially as Peripheral Vascular Disease

Cited by 17 publications

References 22 publications

Polyarteritis nodosa presenting as peripheral vascular disease and acute limb ischemia

Polyarteritis nodosa presenting as peripheral vascular disease and acute limb ischemia

Vasculitides as a rare cause of intermittent claudication

Cerebellar and brainstem infarction secondary to basilar artery dolichoectasia

Contact Info

Product

Resources

About