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A case of systemic polyarteritis nodosa involving bronchial artery

Y J Lee1, S S Park, S Y Kim

  • 1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Hospital, Seoul, Republic of Korea.

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases : Official Journal of WASOG
|February 16, 2011
PubMed

Insights

Polyarteritis nodosa (PAN) rarely affects bronchial arteries. This case highlights PAN presenting with hemoptysis, revealing aneurysms in multiple arteries including the bronchial, renal, and hepatic systems.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Pulmonology

Background:

  • Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis primarily affecting medium-sized muscular arteries.
  • Commonly involves the skin, kidneys, cardiovascular, gastrointestinal, and neurological systems.
  • Bronchial artery involvement in PAN is exceptionally rare.

Observation:

  • A patient presented with hemoptysis as the initial symptom.
  • Initial chest imaging (radiograph and CT angiography) did not identify a bleeding source.
  • Arteriography revealed a bronchial artery aneurysm and multiple aneurysms in renal, hepatic, mesenteric, and small bowel arteries.

Findings:

  • The arteriographic findings were diagnostic of Polyarteritis nodosa (PAN).
  • The case demonstrates a rare presentation of PAN with significant bronchial artery involvement.
  • Multiple systemic arterial aneurysms were identified.

Implications:

  • This case underscores the importance of considering PAN in patients with unexplained hemoptysis, even with rare vascular involvement.
  • Early diagnosis and treatment with immunosuppressants (steroids and cyclophosphamide) are crucial for managing PAN.
  • Highlights the diagnostic utility of angiography in identifying systemic vasculitis and aneurysms.

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