Myositis as the Initial Presentation of Panarteritis Nodosa

Calvo, Romina; Negri, M; Ortiz, Alberto; Roverano, Susana; Paira, Sergio

doi:10.1016/j.reumae.2018.10.005

Cited by 2 publications

(3 citation statements)

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“…[14] There has also been a case report of a patient with PAN who exhibited myositis on muscle biopsy, similar to this report. [15] Second, considering that the areas that showed myopathic potential on follow-up electromyography were the adductor and vastus muscles, the PAN findings may not have been reflected in the hamstring muscle biopsy. The sensitivity of muscle or nerve biopsy in symptomatic areas of PAN is approximately 60% to 70%.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, considering a study that showed that obtaining appropriate vascular tissue through muscle biopsy is difficult because of the small size of the blood vessels, [18,19] it is possible that vascular findings were not observed in this patient because muscle biopsy was performed. Calvo et al [15] reported a patient with PAN who exhibited myositis on muscle biopsy but demonstrated evidence of vasculitis on nerve biopsy.…”

Section: Discussionmentioning

confidence: 99%

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Polyarteritis nodosa initially presenting as concomitant peripheral neuropathy and myositis in unilateral limb: A case report

2023

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Rationale: We report the case of a patient who initially presented with peripheral neuropathy and myositis without typical organ involvement, such as the kidneys, skin, or gastrointestinal system, but was ultimately diagnosed with polyarteritis nodosa (PAN). Patient concerns: A 62-year-old man presented with radicular pain in his right lower extremity. One week later, he complained of right ankle motor weakness and pain in the right posterior thigh, which led to admission. After 6 weeks of hospitalization, he newly experienced pain in his right testicle and anterior thigh. Diagnosis: The patient was initially diagnosed with polymyositis combined with sciatic neuropathy using magnetic resonance imaging, electrodiagnostic tests, and muscle biopsy. However, with the emergence of other systemic symptoms such as testicular pain, vasculitis was suspected, and the patient was reclassified as PAN using the 2007 European Medicines Agency algorithm and the American College of Rheumatology criteria. Interventions: The patient was treated with glucocorticoids for more than 6 months, and antiviral medication was prescribed to prevent hepatitis B virus reactivation. Outcomes: The patient’s radicular pain and pain in the right anterior and posterior thighs and testicle improved, and there were no signs of recurrence. Lessons: In patients presenting with radicular and focal muscle pain, it is crucial to consider the potential for PAN, as observed in this case report.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Polyarteritis nodosa initially presenting as concomitant peripheral neuropathy and myositis in unilateral limb: A case report

2023

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“…The peculiarity of this case lies in its presentation form, localized at the lower limbs, with pain and swelling that could mimic a deep vein thrombosis, soft tissue infection or even a compartment syndrome. Myalgia occur in about 51% of PAN cases, which may be due to the involvement of intramuscular arteries, the involvement of the peripheral nervous system or, more rarely, to myositis [2]. PAN should be considered as a differential diagnosis in cases in which MRI images show diffuse or unequal muscle signal changes.…”

Section: Discussionmentioning

confidence: 99%

Polyarteritis Nodosa: A Rare Form of Presentation

Camões

López

Morales³

2018

BJSTR

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Poly arteritis nodosa (PAN) is a necrotizing vasculitis of medium caliber arteries in which the involvement of small vessels is not typical.The most affected organs are skin, gastrointestinal tract and peripheral nerves. In our case report, PAN presented with pain, swelling and altered sensation of the left leg, mimicking deep vein thrombosis, soft tissue infection or even a compartment syndrome. We present this case to raise awareness to this rare but possible form of PAN presentation, that will need a distinct approach.

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Myositis as the Initial Presentation of Panarteritis Nodosa

Cited by 2 publications

References 6 publications

Polyarteritis nodosa initially presenting as concomitant peripheral neuropathy and myositis in unilateral limb: A case report

Polyarteritis nodosa initially presenting as concomitant peripheral neuropathy and myositis in unilateral limb: A case report

Polyarteritis Nodosa: A Rare Form of Presentation

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