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Massive renal hemorrhage owing to polyarteritis nodosa
J Z Cornfield1, M L Johnson, J Dolehide
1Division of Urology, University of Illinois College of Medicine, Chicago 60680.
The Journal of Urology
|October 1, 1988
Summary
Massive renal hemorrhage from unsuspected polyarteritis nodosa was controlled by renal artery embolization. Characteristic imaging findings on angiography and CT are crucial for urologists to recognize this rare cause of bleeding.
Area of Science:
- Nephrology
- Vascular Surgery
- Radiology
Background:
- Polyarteritis nodosa (PAN) is a rare systemic vasculitis that can affect renal arteries.
- Renal hemorrhage is an uncommon but potentially life-threatening manifestation of PAN.
- Early diagnosis and intervention are critical for managing patients with PAN-related renal complications.
Observation:
- A case of massive renal hemorrhage occurred in a patient with previously undiagnosed polyarteritis nodosa.
- The bleeding was severe, necessitating urgent intervention.
- Diagnostic imaging played a key role in identifying the underlying cause.
Findings:
- Renal angiography revealed findings characteristic of polyarteritis nodosa, including microaneurysms and irregular arterial narrowing.
- Enhanced computerized tomography (CT) corroborated the angiographic findings, further supporting the diagnosis of PAN.
- These imaging findings are considered pathognomonic for the disorder.
Implications:
- This case highlights the importance of considering polyarteritis nodosa in the differential diagnosis of massive renal hemorrhage.
- Renal artery embolization is an effective treatment modality for controlling active bleeding in such cases.
- Familiarity with the characteristic imaging findings of polyarteritis nodosa on angiography and CT is essential for urologists and radiologists.