Does spontaneous remission occur in polyarteritis nodosa?
| Autor: | Peter Vollenweider, Matthieu Halfon, Simon Beyaert, Menno Pruijm, Salah D. Qanadli |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cyclophosphamide Remission Spontaneous Spontaneous remission Thrombophilia Kidney Diagnosis Differential Biopsy Medicine Humans Medical history Glucocorticoids medicine.diagnostic_test business.industry Polyarteritis nodosa General Medicine Middle Aged medicine.disease Polyarteritis Nodosa Nephrology Infarction Female Radiology Differential diagnosis business Immunosuppressive Agents Systemic vasculitis medicine.drug |
| Zdroj: | Clinical nephrology. 87(5) |
| ISSN: | 0301-0430 |
| Popis: | BACKGROUND Polyarteritis nodosa (PAN) is a systemic vasculitis involving mainly medium-sized arteries and, rarely, small-sized arteries. The diagnosis is principally based on clinical exams, biopsy of an affected organ, and/or arteriography of renal or mesenteric arteries. Once diagnosed, immunosuppressive agents, such as glucocorticoids and cyclophosphamide, are generally introduced as soon as possible. Whether spontaneous remission of PAN occurs is therefore largely unknown. PRESENTATION We describe the case of a 51-year-old woman who presented with a 4-day-history of intense pain in her left flank, hypertension, fever, microscopic hematuria, and acute renal failure. Contrast-enhanced renal ultrasound strongly suggested bilateral renal infarction. Medical history and an extensive workup allowed to exclude systemic embolism, recreational drug abuse, cardiac arrhythmias, and thrombophilia. A possible diagnosis of PAN was considered; however, within 2 weeks of admission, spontaneous remission of her clinical and biological symptoms occurred without the use of any immunosuppressive treatment. Finally, 3 months later, renal arteriography confirmed the diagnosis of PAN. The patient remains free of symptoms 1 year after initial presentation. CONCLUSION This case illustrates the importance of considering PAN in the differential diagnosis of renal infarction with inflammatory syndrome and shows that spontaneous remission of renal PAN can occur. . |
| Databáze: | OpenAIRE |
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