Polyarteritis nodosa with pulmonary vasculitis

Although early postmortem series reported pulmonary involvement as a relatively common manifestation of polyarteritis nodosa (PAN), using the modern classification of PAN pulmonary involvement is very uncommon. A 62-yr-old male with well-documented classic PAN was found to have an arteritis of medium-sized muscular pulmonary arteries. The patient subsequently demonstrated a complete response to treatment. Of the few reported cases of PAN with pulmonary manifestations, the majority are autopsy series and the vascular lesion involves the bronchial arteries. There are no case reports of patients with pulmonary involvement of PAN who responded successfully to treatment. This case is the first description of a premortum diagnosis of pulmonary arteritis in PAN in which the patient had a response to treatment.