Ces radiol. 2020, 74(1):43-46 | DOI: 10.55095/CesRadiol2020/008

Polyarteritis nodosa: Case report and review of the literatureCase report

Milan Vajda1, Petr Hoffmann1, Alice Jansová2, Michal Hůlek1, Jana Draganovičová1, Ondřej Živný1, Pavla Čabelková1
1 Radiologická klinika LF UK a FN, Hradec Králové
2 II. interní gastroenterologická klinika - subkatedra revmatologie LF UK a FN, Hradec Králové

We present a case of a patient with a newly diagnosed vasculitis of polyarteritis nodosa, that manifested itself by macroscopic hematuria, secondary hypertension and multiple infarctions in both kidneys. Imaging methods revealed multiple small aneurysms of the renal arteries that caused occlusion of their segmental branches and consequently led to partial ischemia of the parenchyma. Asymptomatic aneurysms on branches of proper hepatic artery and dissection of left common and external iliac artery were also diagnosed. Digital subtraction angiography is considered to be the gold standard of imaging in polyarteritis nodosa, although it could be replaced by CT angiography due to its rapid advances.

Keywords: aneurysm, polyarteritis nodosa, vasculitis

Accepted: January 30, 2020; Published: March 1, 2020  Show citation

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Vajda M, Hoffmann P, Jansová A, Hůlek M, Draganovičová J, Živný O, Čabelková P. Polyarteritis nodosa: Case report and review of the literature. Ces radiol. 2020;74(1):43-46. doi: 10.55095/CesRadiol2020/008.
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References

  1. Hernández-Rodríguez J, Alba MA, Prieto-González S, Cid MC. Diagnosis and classification of polyarteritis nodosa. J Autoimmun 2014; 48-49: 84-89. Go to original source... Go to PubMed...
  2. Tesar V, Kazderová M, Hlavácková L. Rokitansky and his first description of polyarteritis nodosa. J Nephrol 2004; 17(1): 172-174.
  3. De Virgilio A, Greco A, Magliulo G, et al. Polyarteritis nodosa: A contemporary overview. Autoimmun Rev 2016; 15(6): 564-570. Go to original source... Go to PubMed...
  4. Forbess L, Bannykh S. Polyarteritis nodosa. Rheum Dis Clin North Am 2015; 41(1): 33-46 Go to original source... Go to PubMed...
  5. Trepo C, Thivolet J. Hepatitis associated antigen and periarteritis nodosa (PAN). Vox Sang 1970; 19: 410-411. Go to original source...
  6. Ebert EC, Hagspiel KD, Nagar M, Schlesinger N. Gastrointestinal involvement in polyarteritis nodosa. Clin Gastroenterol Hepatol 2008; 6(9): 960-966. Go to original source... Go to PubMed...
  7. González-Gay MA, García-Porrúa C, Guerrero J, et al. The epidemiology of the primary systemic vasculitides in northwest Spain: im-plications of the Chapel Hill consensus conference definitions. Arthritis Rheum 2003; 49(3): 388-393. Go to original source... Go to PubMed...
  8. Ewald EA, Griffin D, McCune WJ. Correlation of angiographic abnormalities with disease manifestations and disease severity in polyarteritis nodosa. J Rheumatol 1987; 14(5): 952-956.
  9. Bae YD, Choi HJ, Lee JC, et al. Clinical Features of Polyarteritis Nodosa in Korea. J Korean Med Sci 2006; 21(4): 591-595. Go to original source... Go to PubMed...
  10. Stanson AW, Friese JL, Johnson CM, et al. Polyarteritis nodosa: spectrum of angiographic findings. Radiographics 2001; 21(1): 151-159. Go to original source... Go to PubMed...
  11. Hekali P, Kajander H, Pajari R, Stenman S, Somer T. Diagnostic significance of angiographically observed visceral aneurysms with regard to polyarteritis nodosa. Acta Radiol 1991; 32(2): 143-148. Go to original source...
  12. Gupta V, Chinchure SD, Goel G, et al. Coil Embolization of Intracranial Aneurysm in Polyarteritis Nodosa. A Case Report and Review of the Literature. Interv Neuroradiol 2013; 19(2): 203-208. Go to original source... Go to PubMed...
  13. Toyoda K, Tsutsumi K, Hirao T, et al. Ruptured Intracranial Aneurysms in Pediatric Polyarteritis Nodosa. Neurol Med Chir 2012; 52: 928-932. Go to original source... Go to PubMed...
  14. Tarhan NC, Coskun M, Kayahan EM, Yildirim E, Yucel E. Regression of Abdominal Visceral Aneurysms in Polyarteritis Nodosa: CT Findings. Am J Roentgenol 2003; 180: 1617-1619. Go to original source... Go to PubMed...
  15. Singhal M, Gupta P, Sharma A, et al. Role of multidetector abdominal CT in the evaluation of abnormalities in polyarteritis nodosa. Clin Radiol 2016; 71(3): 222-227. Go to original source... Go to PubMed...
  16. Fauci AS, Doppman JL, Wolff SM. Cyclophosphamide-induced remissions in advanced polyarteritis nodosa. Am J Med 1978; 64(5): 890-894. Go to original source... Go to PubMed...
  17. Watanabe TT, Shiojiri T. PET-CT and polyarteritis nodosa-associated artery aneurysms. Int J Med 2019; 112(3): 219-220. Go to original source... Go to PubMed...
  18. Chrapko B, Chrapko M, Nocuń A, et al. Role of 18F-FDG PET/CT in the diagnosis of inflammatory and infectious vascular disease. Nuclear Med Rev 2016; 19(1): 28-36. Go to original source... Go to PubMed...
  19. Tang S, Niu G, Fang D, et al. The diagnosis and endovascular therapy of renal artery aneurysm: A 32-patient case report. Medicine 2017; 96(47). Go to original source... Go to PubMed...
  20. Stambo GW, Guiney MJ, Cannella XF, Germain BF. Coil embolization of multiple hepatic artery aneurysms in a patient with undiagnosed polyarteritis nodosa. J Vasc Surg 2004; 39(5): 1122-1124. Go to original source... Go to PubMed...
  21. Hidalgo J, Crego M, Montlleo M, et al. Embolization of a Bleeding Aneurysm in a Patient with Spontaneous Perirenal Haematoma due to Polyarteritis Nodosa. Arch Esp Urol 2005; 58(7): 694-697. Go to original source... Go to PubMed...
  22. Gómez-Luque I, Alconchel F, Ciria R, et al. Spontaneous liver rupture as first sign of polyarteritis nodosa. World J Hepatol 2016; 8(32): 1414-1418. Go to original source... Go to PubMed...
  23. Mukhopadhyay P, Rathi M, Kohli HS, et al. Polyarteritis nodosa presenting with spontaneous perirenal hematoma. Indian J Nephrol 2012; 22(4): 295-297. Go to original source... Go to PubMed...
  24. Roberto M, Meytes V, Liu S. Ruptured hepatic aneurysm as first presenting symptom of polyarteritis nodosa. Oxf Med Case Reports 2018; 2: 64-67. Go to original source... Go to PubMed...

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