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Polyarteritis nodosa complicated by antiphospholipid syndrome
Jorge L Musuruana1, Javier A Cavallasca
1Section of Rheumatology and Autoimmune Diseases, Hospital JB Iturraspe, Santa Fe, Argentina. reumatologia.iturraspe@gmail.com
Southern Medical Journal
|March 25, 2008
Summary
Polyarteritis nodosa, a vasculitis affecting medium arteries, can rarely coexist with Antiphospholipid Syndrome. This case highlights severe leg ischemia and amputation in a patient with both conditions despite treatment.
Area of Science:
- Rheumatology
- Immunology
- Vascular Medicine
Background:
- Polyarteritis nodosa (PAN) is a necrotizing vasculitis of small to medium arteries.
- Antiphospholipid Syndrome (APS) is an autoimmune disorder causing thrombosis and/or pregnancy morbidity, linked to antiphospholipid antibodies.
- The co-occurrence of PAN and APS is rare.
Observation:
- A male patient with a confirmed diagnosis of PAN presented with leg ischemic lesions 7 years after his vasculitis diagnosis.
- Elevated anticardiolipin antibody titers were detected.
- Angiographic and histologic findings confirmed thrombosis.
Findings:
- The patient developed severe ischemic lesions in both legs.
- Despite treatment with immunosuppressants and anticoagulants, the lesions progressed.
- Bilateral leg amputation was ultimately required.
Implications:
- This case underscores the potential for severe vascular complications when PAN and APS overlap.
- It highlights the challenges in managing coexisting autoimmune and thrombotic disorders.
- Further research may be needed to optimize treatment strategies for this rare clinical entity.
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