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Polyarteritis nodosa complicated by posterior reversible encephalopathy syndrome: a case report
Insights
This study highlights a rare case of secondary hypertension caused by Polyarteritis Nodosa (PAN). The findings link PAN to microaneurysms and PRES syndrome, emphasizing the need for broader diagnostic considerations in hypertension.
Area of Science:
- Nephrology
- Neurology
- Rheumatology
Background:
- Hypertension (HT) is a global health issue and a significant risk factor for cardiovascular and cerebrovascular diseases.
- Secondary hypertension, accounting for 5-10% of cases, arises from specific underlying mechanisms.
- Common causes include renal diseases, primary hyperaldosteronism, pheochromocytoma, and Cushing's syndrome.
Observation:
- Polyarteritis Nodosa (PAN) is a vasculitis that can affect multiple organs.
- This case involves a young patient with hypertension secondary to PAN.
- Angiographic findings revealed multiple microaneurysms in the celiac, renal, and superior mesenteric arteries.
Findings:
- The patient presented with secondary hypertension.
- Diagnosis of Polyarteritis Nodosa (PAN) was confirmed.
- Associated findings included multiple arterial microaneurysms and Posterior Reversible Encephalopathy Syndrome (PRES).
Implications:
- This case underscores the importance of considering rare causes like PAN in secondary hypertension.
- The association with microaneurysms and PRES syndrome highlights a complex clinical presentation.
- Early diagnosis and management of PAN are crucial to prevent severe complications of hypertension and vasculitis.
Abstract:
Hypertension (HT) represents a major public health problem affecting many individuals worldwide. It is well known to be an important risk factor for the development of cerebrovascular and cardiovascular diseases. Classifying hypertension as ‘primary’ or ‘secondary’ depends on the underlying mechanism. In 5 to 10% of hypertensive patients, HT develops ‘secondary’ to a separate mechanism that has been encountered with increasing frequency in the tertiary refferral centers. The frequent causes of secondary hypertension include renal parenchymal disease, renal artery stenosis, primary hyperaldosteronism, phaeochromocytoma and Cushing's syndrome. Polyarteritis nodosa (PAN) can involve any organ and in varying degrees. Here we present a young hypertensive patient diagnosed as PAN with the angiographic findings of multiple microaneurysms involving celiac, renal and superior mesenteric arteries and associated with a rarely seen neurological entity-PRES syndrome.
