Angiographic Findings in Systemic Necrotizing Vasculitis

Abstract

Angiographic studies were carried out on 21 patients with systemic necrotizing vasculitis. Four basic arterial anomalies were found: (1) saccular microaneurysms appeared in 62% of the patients (2) arterial thrombosis was seen in 81% of patients; (3) arterial stenosis occurred in 81%; and (4) lumen irregularities occurred in 90%. Alterations in the renal vascular flow were also observed in accordance with changes in the cortical medullary differentiation, heterogeneous nephrogram, and prolonged washout. Two patients showed regression of microaneurysms after immunosuppressive therapy. We found angiography to be a low-risk technique of use for diagnosis and followup studies on vasculitis.

Polyarteritis Nodosa and Necrotizing Glomerulonephritis Associated with Long-Standing Silicosis

“…Serum complement components were normal and serologic tests for systemic lupus erythematosus (SLE), HBV infection, circulating immune complexes, cryoimmunoglobulins and antiglomerular basement membrane antibodies were nega tive. In the absence of drug addiction, allergy history, eosinophilia or disorders like SLE or atrial mixoma, the finding of multiple intraparenchymal saccular aneu rysms demonstrable by renal angiography is virtually diagnostic of classic PAN [15,16]. In our patient, the glomerular lesions consisted in necrotizing glomerulon ephritis, an uncommon histological entity responsible for only 5% of all glomérulonéphrites according to a recent report [17], but the most frequent histological finding in patients with classic PAN.…”

Dramatic regression of mesenteric abnormalities demonstrated on angiography following prednisolone and cyclophosphamide combination therapy in a patient with polyarteritis nodosa associated with Sjögren’s syndrome

“…It has been suggested that the angiographic demonstration of aneurysms in PAN might identify a group of PAN patients with greater disease severity [20][21][22]. However, not all patients suffering from histologically verified PAN have angiographically demonstratable aneurysms [15]. Studies on angiographic changes in patients with PAN have been scarce, and controversy persists over what produces the regression of microaneurysms.…”

“…Multiple colonic ulcers often occur in PAN, and digestive organ lesions are important indicators of the prognosis. The diagnostic indicators of abnormal abdominal angiography findings due to PAN have been established [14,15], and included in the ACR classification criteria [7], but their improvement has not been closely described.…”

Isolated celiac artery aneurysm with splenic artery stenosis as a rare presentation of polyarteritis nodosum: A case report and review of the literature

“…10 Other, less specific, findings on angiography include arterial stenosis, thrombosis, and occlusion. 11 The sensitivity and specificity of angiography in the diagnosis of PAN is reported to be 89% and 90%, respectively. 10 Arterial occlusions may result in end-organ damage from infarction and are often first identified on CT scan during initial workup.…”