Related Experiment Video
Updated: Sep 30, 2025
13:01
Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
135.5K
A Rare Presentation of Polyarteritis Nodosa
Ciji Robinson1, Zarqa Yasin1, Parth Patel1
1Internal Medicine, Henry Ford Health System, Jackson, USA.
Cureus
|March 11, 2022
Summary
Polyarteritis nodosa (PAN), a rare vasculitis, can affect multiple organs. This case highlights mesenteric artery involvement diagnosed via CTA and treated successfully with steroids, even without biopsy confirmation.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Immunology
Background:
- Polyarteritis nodosa (PAN) is a rare, necrotizing medium-vessel vasculitis with potential for systemic organ damage.
- Commonly affects skin, renal, neurologic, and musculoskeletal systems, with diagnosis often confirmed by biopsy.
- Mesenteric artery involvement in PAN, while less common, presents diagnostic and therapeutic challenges.
Observation:
- A 66-year-old female presented with chest and epigastric pain.
- Computed tomography angiography revealed characteristic PAN findings in the mesenteric arteries: alternating narrowing and aneurysmal dilation.
- Biopsy of the affected mesenteric arteries was deemed too risky and not performed.
Findings:
- Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) supported systemic inflammation.
- Extensive infectious disease workup yielded negative results, ruling out infectious causes.
- Clinical improvement and full recovery following high-dose steroid therapy strongly indicated PAN.
Implications:
- This case underscores the utility of computed tomography angiography in diagnosing PAN, particularly when biopsy is contraindicated.
- It highlights the effectiveness of high-dose steroids as a primary treatment for PAN, even in complex cases with mesenteric involvement.
- The successful management emphasizes the importance of considering PAN in patients with unexplained abdominal pain and inflammatory markers, even without typical organ involvement.
Related Concept Videos
01:25Endocarditis II: Clinical Features of Infective Endocarditis
35
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
35
01:30Peripheral Artery Disease I: Introduction
58
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
58
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
44
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
44
01:24Nephrotic Syndrome I : Introduction
42
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
42
01:23Rheumatic Heart Disease I: Introduction
69
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
69
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
96
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
96