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[Two cases of polyarteritis nodosa with a good prognosis?]
1Service de médecine interne B, hôpital Saint-Eloi, 2, avenue Bertin-Sans, 34295 Montpellier, France. bernard.simorre@wanadoo.fr
Introduction:
Polyarteritis nodosa is a systemic necrotizing vasculitis that may become serious, even with no usual poor prognosis factors.
Exegesis:
We report two cases of polyarteritis nodosa with negative histology, starting only with an extensive necrosis of the extremities. The treatment, associating corticosteroids and, secondarily, immunosuppressors, did not prevent a bilateral half-leg amputation for the two patients. In the first case the disease stabilized, but in the second one, it worsened, leading to death within 2 years.
Conclusion:
This clinical aspect of the disease is unusual and should be identified because of its bad prognosis. It might benefit from a treatment from the outset associating corticosteroids and immunosuppressors, even with no usual bad prognosis factors.
