Polyarteritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide

Harada, Masaru; Yoshida, Hiroshi; Ikeda, Hideo; Yoshida, Takafumi; Takedatsu, Hidetoshi; Nagamatsu, Hiroaki; Koga, Kenshi; Fujisawa, Yuko; Sakamoto, Masaharu; Fujisaki, Kazuhiro; Sakisaka, Shotaro; Yasumoto, Kiyoshi; Toyonaga, Atsushi; Sata, Michio

doi:10.1007/s005350050323

Cited by 14 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, three cases with apparent improvement of abdominal angiographic findings on the proximal of middle size abdominal artery have been reported [27][28][29]. The primary disease rapidly remitted following concomitant steroid and CY treatment, and abdominal angiographic findings were improved in all patients ( Table 1).…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2008

View full text Add to dashboard Cite

A 63-year-old woman, who had been followed for Sjögren's syndrome, was admitted due to cryoglobulinemia, leukocytoclastic vasculitis, and mononeuritis multiplexa. In spite of the administration of 60 mg prednisolone, fecal occult blood was strongly positive. The colonoscopy showed multiple colonic ulcers, and a diagnosis of polyarteritis nodosa (PAN) was made because abdominal angiography revealed markedly serpentine and narrowed superior and inferior mesenteric arteries. After steroid pulse therapy and daily oral administration of cyclophosphamide were initiated, her symptoms improved and abdominal angiographic findings were finally normalized. Although there are only three case reports on improvements in abdominal angiographic findings of PAN in the literature, our case and previously reported cases suggest that improvements in angiographic findings may reflect a good prognosis of PAN.

show abstract

Section: Discussionmentioning

confidence: 86%

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

et al. 2008

View full text Add to dashboard Cite

show abstract

“…2,7,8 The major gastrointestinal complications are ulceration, perforation, hemorrhage, and obstruction. 2,8,9 Catastrophic and massive intestinal bleeding is rare unless the aneurysm ruptures into the intestine. The mortality rate can be as high as 75% in these cases.…”

Section: Discussionmentioning

confidence: 99%

Fatal Polyarteritis Nodosa With Gastrointestinal Involvement in a Child

Kendirli

Yüksel²,

Oral³

et al. 2006

Pediatric Emergency Care

View full text Add to dashboard Cite

Polyarteritis nodosa (PAN) is a necrotizing angiitis that predominantly affects small- and medium-sized arteries. Polyarteritis nodosa occurs rarely during childhood. Boys and girls seem to be equally affected, with a peak at the age of 10 years. Rarely, severe and fatal gastrointestinal involvement is seen in PAN. Here, we report a 15-year-old boy with PAN, who had gastrointestinal involvement with multiple aneurysms of the hepatic and superior mesenteric arteries. This involvement could be demonstrated with conventional angiography and gastrointestinal bleeding scintigraphy. The progression of the symptoms and the decrease in the size of the aneurysms were noted after combination treatment with cyclophosphamide and prednisolone, but there was severe bleeding from small bowel, and it was taken under control by resection of jejunum. However, the patient died because of sepsis. In conclusion, severe gastrointestinal involvement in PAN is usually fatal despite aggressive therapy, as is the case in our patient.

show abstract

“…The FFS of the case was 2, based on multiple bilateral renal aneurysms and failure to achieve remission by glucocorticoid monotherapy. A previous report indicated that cyclophosphamide therapy may improve microaneurysms of PAN [20] and is recommended for cases of PAN with an FFS ≧ 1 as induction therapy [3]. We, therefore, administered cyclophosphamide, resulting in remission.…”

Section: Discussionmentioning

confidence: 99%

Polyarteritis nodosa with perirenal hematoma due to the rupture of a renal artery aneurysm

et al. 2020

View full text Add to dashboard Cite

We present the case of a 67-year-old man in good health with perirenal hematoma due to a ruptured arterial aneurysm in the kidney. The patient developed weight loss, muscle weakness, multiple mononeuropathy, hypertension, anemia, renal insufficiency, and multiple lacuna infarctions about a month ago. He was admitted to the hospital due to worsening of his symptom. After admission, severe right-flank pain suddenly occurred; he was then transferred to our hospital. Renal angiography revealed bilateral multiple microaneurysms, and the patient was diagnosed with polyarteritis nodosa based on the clinical, radiographic, and histological findings. We performed selective coil embolization to the ruptured aneurysm and administered oral prednisolone along with intravenous methylprednisolone pulse therapy. Cyclophosphamide pulse therapy was also given. The treatment improved clinical and laboratory findings and achieved clinical remission. Selective coil embolization to the bleeding aneurysm of polyarteritis nodosa was minimally invasive and promptly effective. Immunosuppressants proved useful in the regulation of disease activity and the aneurysm.

show abstract

Polyarteritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide

Cited by 14 publications

References 12 publications

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

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

Fatal Polyarteritis Nodosa With Gastrointestinal Involvement in a Child

Polyarteritis nodosa with perirenal hematoma due to the rupture of a renal artery aneurysm

Contact Info

Product

Resources

About