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Polyarteritis nodosa

Chrong-Reen Wang, Chao-Chun Yang
INTRODUCTION: Polyarteritis nodosa (PAN) is a difficult-to-treat rheumatology disorder, and biologic agents have been used in such patients with a treatment failure or the disease relapse. CASE PRESENTATION: We report a 42-year-old male Han Chinese who received adalimumab (ADA) alone during his vasculitis relapse, manifesting with weight loss, ankle arthritis, testicular inflammation and new-onset hypertension. Under the ADA 40 mg biweekly subcutaneous injection, there were the disappearance of clinical activity and no disease flares with a follow-up period of 26 months...
June 2018: Medicine (Baltimore)
Vítor Teixeira, Filipa Oliveira-Ramos, Manuela Costa
No abstract text is available yet for this article.
June 18, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Elif Bulut, Abdulsamet Erden, Omer Karadag, Kader Karli Oguz, Seza Ozen
PURPOSE: To increase the knowledge of central nervous system (CNS) imaging features in deficiency of adenosine deaminase 2 (DADA2) by examining magnetic resonance imaging (MRI) studies of a relatively large number of patients. METHODS: We retrospectively examined neuroimages of 12 patients (7 male, 5 female) diagnosed with DADA2. The mean age of the patients at the time of initial brain MRI was 16.7±10.2 years. Seven patients (58.3%) fulfilled the classification criteria of polyarteritis nodosa...
June 15, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Joe James, James Jose, Nallaveettil Kesavan Thulaseedharan
Necrotizing vasculitic neuropathy in polyarteritis nodosa can rarely present acutely and may mimic acute inflammatory neuropathies. A 53-year-old male presented with an acute neurological illness characterized by paresthesia and weakness of both lower limbs lasting six-days. He also had mild paresthesia of both hands. On examination, there were confluent, purpuric, and ecchymotic patches over the extensor aspects of both lower limbs, which were palpable. Neurological examination revealed grade II/V power with hypotonia and absent reflexes in the lower limbs...
May 2018: Oman Medical Journal
Line Uhrenholt, Lars S Jensen, Thomas S Jakobsen, Salome Kristensen, Jens Frederik Dahlerup, Einar Pahle, Michael F Nielsen
Mesenteric vasculitis is the most common abdominal manifestation of vasculitis and can present as acute abdominal pain. Mesenteric vasculitis is most frequent in systemic lupus erythematosus and polyarteritis nodosa in adulthood and immunoglobulin A-vasculitis in childhood. Involvement of other organs is also seen. The diagnosis can be challenging, but detailed clinical assessment in combination with diagnostic tests often identifies the underlying cause. Medical treatment is used, when the abdominal manifestation is considered reversible, while surgery is used in unstable patients or patients with non-reversible conditions...
June 11, 2018: Ugeskrift for Laeger
Monika Turska, Jolanta Parada-Turska
Cutaneous polyarteritis nodosa is a rare disease that affects vessels of the deep skin and the subcutaneous tissue. Its etiopathology remains unknown. It predominantly affects skin, and the main cutaneous symptoms are subcutaneous nodules, livedo reticularis, and ulcerations that are mainly located on legs. Cutaneous polyarteritis nodosa can also cause extracutaneous symptoms (fever, malaise, myalgias, arthralgias, neuropathy). It is a chronic benign disease with a relapsing course. Diagnostic criteria for this disease were recently proposed and both clinical and typical histological features must be present to confirm the diagnosis...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Jolanta Parada-Turska, Monika Turska
Polyarteritis nodosa is a systemic necrotizing vasculitis which predominantly affects medium-sized arteries. It is a rare disease nowadays. Both the nomenclature and the classification of polyarteritis nodosa was amended several times in the past. Currently, there is a distinction between the primary form described as classical polyarteritis nodosa and other forms that are associated with their probable cause e.g. with viral hepatitis B, C or HIV infection. Moreover, polyarteritis-like necrotizing vasculitis can appear in the course of genetic diseases caused by mutations in single genes...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Daisuke Nango, Hiroki Nakashima, Yukifumi Hirose, Masaaki Shiina, Hirotoshi Echizen
Background: A causal relationship between acute pancreatitis and administration of glucocorticoids remains a matter of debate, since most of the reported cases were diagnosed with systemic vascular diseases (including systemic lupus erythematosus and polyarteritis nodosa) that may be responsible for the pancreatitis. Case presentation: We report a case of a 51-year-old woman who developed acute pancreatitis after receiving methylprednisolone pulse therapy for the treatment of fulminant autoimmune hepatitis (AIH)...
2018: Journal of Pharmaceutical Health Care and Sciences
Oded Shamriz, Yehuda Shoenfeld
PURPOSE OF REVIEW: Infections play a role in the pathogenesis of autoimmune diseases (AID). Several bacterial and viral pathogens play a double role, as both inducers and inhibitors of AID. In this review, we will present current evidence and discuss different aspects of this notion. RECENT FINDINGS: Infectors that both inhibit and induce AID include Helicobacter pylori, Klebsiella pneumoniae, hepatitis B virus, group B Coxsackieviruses, Epstein-Barr virus and Lymphocytic choriomeningitis virus...
July 2018: Current Opinion in Rheumatology
Mahathi B Indaram, Ibrahim M Saeed, Harshal Patil, Randall C Thompson
No abstract text is available yet for this article.
May 25, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Jan H Schirmer, Frank Moosig
Polyarteritis nodosa (PAN) is a necrotizing arteritis of medium-sized vessels, which is often fatal if untreated. It frequently affects the skin (nodules and ulcers), the peripheral nervous system (mononeuritis multiplex) and the visceral vessels (stenoses and microaneurysms). The complex diagnostic work-up requires discriminating PAN from infectious, malignant, drug-induced and other inflammatory conditions. It can be subclassified into further variants (idiopathic, associated with hepatitis B, associated with hereditary inflammatory diseases or isolated cutaneous disease)...
May 28, 2018: Zeitschrift Für Rheumatologie
Michelle Jung, Lillian Barra
OBJECTIVES: Infections are common complications of necrotising vasculitis. We aimed to determine the rate of infections in patients with severe necrotising vasculitis treated with cyclophosphamide (CYC) combined with high dose glucocorticoids (GC). METHODS: Searches of MEDLINE, Embase and Cochrane Library databases (1990 to May 2016) were performed. Inclusion criteria were randomised controlled trials of intravenous (IV) or oral (PO) CYC induction therapy for granulomatosis and polyangiitis (GPA), microscopic poyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), and systemic polyarteritis nodosa (PAN)...
March 2018: Clinical and Experimental Rheumatology
Tetyana I Yarmola, Tetyana B Bevzenko, Lydia A Tkachenko, Victoria V Talas, Anna L Pustovoyt
Polyarteritis nodosa is a chronic systemic vasculitis, characterized by the autoimmune, necrotising lesion of the walls of the small- and medium-bore visceral and peripheral arteries, resulting in vessel aneurysms and the secondary degeneration of organs and systems. All types of vessels (arteries, veins, capillaries) can be affected or, alternatively, the process can be limited predominantly to the vessels of one system, the clinical symptoms depending on the bore and location of the affected vessels. Varying degrees of the lesion, varying combinations and sequencing, the compensation abilities of the vessel disorders can blur the clinical picture, even though early pathomorphological changes are quite pronounced...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Sajad Hasanzadeh, Seyedeh Maryam Alavi, Elahe Masnavi, Maryam Rohani, Saeid Jokar
Background: Polyarteritis nodosa (PAN) is a vasculitis that affects medium sized arteries. PAN is a rare disease and requires a high vilgilance for diagnosis. For instance, PAN and Henoch-Schonlein purpura (HSP) have narrowing differential diagnosis. Here, we report a case of PAN. Case presentation : Our patient was a 65 year old woman that came to hospital due to abdominal pain and skin lesion on the right upper and right lower extremities. All rheumatologic tests were negative. A biopsy of the skin lesion was reported as mild hyperkeratosis, slight spongiosis with intact basal layer...
2018: F1000Research
L Salgado-Lopez, C de Quintana-Schmidt, I Catala-Antunez, J Aibar-Duran, L San Roman-Manzanera, J Molet-Teixido
INTRODUCTION: Polyarteritis nodosa is a necrotizing vasculitis that mainly affects small and medium-sized arteries in skin and internal organs. Neurological involvement is reported in around 25% of cases: ischemic stroke is relatively common, but haemorrhagic lesions are extremely rare. Subarachnoid haemorrhage in polyarteritis nodosa is an uncommon expression of this disease, mostly associated with aneurism rupture. To the best of the authors' knowledge, there is just one published case in pediatric age with polyarteritis nodosa and subarachnoid haemorrhage with no underlying aneurismal disease...
May 16, 2018: Revista de Neurologia
Léo Caudrelier, Grégory Pugnet, Léonardo Astudillo, Xavier Delbrel, Alessandra Bura Riviere, Laurent Sailler
No abstract text is available yet for this article.
March 2018: Clinical and Experimental Rheumatology
Sabine Jardel, Xavier Puéchal, Alain Le Quellec, Christian Pagnoux, Mohamed Hamidou, François Maurier, Olivier Aumaitre, Achille Aouba, Thomas Quemeneur, Jean-François Subra, Vincent Cottin, Jean Sibilia, Pascal Godmer, Patrice Cacoub, Anne Laure Fauchais, Eric Hachulla, Delphine Maucort-Boulch, Loïc Guillevin, Jean-Christophe Lega
OBJECTIVE: The aim of the study was to describe the evolution of mortality and cause-specific mortality over time in patients with systemic necrotizing vasculitides (SNV), including polyarteritis nodosa (PAN), granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). METHODS: Patients with SNV from the French Vasculitis Study Group registry were divided into 5 groups according to the date of diagnosis: <1980, 1980-1989, 1990-1999, 2000-2010, and ≥ 2010...
May 3, 2018: Autoimmunity Reviews
Alina Casian, Shirish Sangle, David P D'Cruz
Antimalarials have been an effective and safe treatment for autoimmune rheumatic diseases such as systemic lupus erythematosus for more than a hundred years. There are surprisingly few reports of hydroxychloroquine use in the systemic vasculitides. Hydroxychloroquine has antithrombotic, cardiovascular, antimicrobial and antineoplastic effects, making it a potentially valuable treatment for patients with systemic vasculitis who are at risk of infections, malignancy and thrombotic events. We report the successful use of hydroxychloroquine in patients with ANCA vasculitis, Henoch Schonlein purpura/IgA vasculitis, Takayasu's arteritis and polyarteritis nodosa...
May 2, 2018: Autoimmunity Reviews
Karalanglin Tiewsoh, Ankur Kumar Jindal, Dhrubajyoti Sharma, Sunil Arora, Ranjana W Minz, Parimal Agrawal, Ritambhra Nada, Deepti Suri
There is a paucity of literature on renal diseases associated with HIV infection in Asian countries. Renal disease in HIV-infected children can involve the glomerulus, interstitium, tubules or blood vessels of the kidney. In this case series, five HIV-infected children with various forms of renal disease are reported. The renal pathology included HIV-associated nephropathy, collapsing focal segmental glomerulosclerosis without tubular changes, tubule-interstitial nephritis and minimal change disease (MCD). Case five fulfilled the classification criteria for childhood polyarteritis nodosa (PAN)...
May 4, 2018: Paediatrics and International Child Health
Gleice Clemente, Clovis A Silva, Silvana B Sacchetti, Virginia P L Ferriani, Sheila K Oliveira, Flavio Sztajnbok, Blanca E R G Bica, André Cavalcanti, Teresa Robazzi, Marcia Bandeira, Maria Teresa Terreri
Juvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses...
June 2018: Rheumatology International
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