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Polyarteritis nodosa presenting as temporal arteritis in a 9-year-old child
R J Bert1, V P Antonacci, L Berman
1Department of Radiology, Boston Medical Center, MA 02118, USA.
AJNR. American Journal of Neuroradiology
|February 12, 1999
Summary
A rare case of pediatric polyarteritis nodosa presented initially as isolated temporal arteritis and monocular blindness. This presentation is unusual for both polyarteritis nodosa and giant cell arteritis in children.
Area of Science:
- Pediatric Rheumatology
- Vascular Inflammation
Background:
- Giant cell arteritis and polyarteritis nodosa are rare in children.
- Temporal arteritis is a known manifestation of giant cell arteritis.
Observation:
- A 9-year-old girl presented with monocular blindness and temporal arteritis.
- Initial workup showed elevated inflammatory markers and a history of hearing loss.
- Corticosteroid treatment was ineffective.
Findings:
- Biopsy and imaging confirmed temporal arteritis, initially suggesting giant cell arteritis.
- Subsequent development of systemic illness, encephalopathy, and widespread aneurysms confirmed polyarteritis nodosa.
- This initial presentation is unprecedented in pediatric cases of either condition.
Implications:
- Highlights the importance of considering polyarteritis nodosa in pediatric cases of temporal arteritis, especially with treatment failure.
- Suggests a broader differential diagnosis for pediatric vasculitis.
- Emphasizes the need for comprehensive systemic evaluation in pediatric vasculitis.