1.Polyangiitis overlap syndrome: cutaneous leukocytoclastic vasculitis associated with polyarteritis nodosa.
Chan Kum PARK ; Young Hae KO ; Moon Hyang PARK ; Jung Dal LEE ; Chang Woo LEE
Journal of Korean Medical Science 1994;9(3):243-247
A rare case of polyangiitis overlap syndrome is described. The patient was a 25-year-old man who had palpable purpura on his legs which showed leukocytoclastic vasculitis, and polyarteritis nodosa. Superior mesenteric arteriography showed microaneurysms in jejunal branches with focal segmental necrotizing arteritis of small and medium sized muscular arteries in the jejunum. Deposits of IgA and C3 in the superficial blood vessels of the lesional skin were consistent with the features of Henoch-Schonlein purpura. The patient died about two months after initial admission in spite of cytotoxic agent and steroid administration.
Adult
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Case Report
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Human
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Male
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Polyarteritis Nodosa/*complications/pathology
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Vasculitis, Hypersensitivity/*complications/pathology
2.Hemobilia from Ruptured Hepatic Artery Aneurysm in Polyarteritis Nodosa.
Sung Soon PARK ; Byeong Uk KIM ; Hye Suk HAN ; Ja Chung GOO ; Joung Ho HAN ; Il Hun BAE ; Seon Mee PARK
The Korean Journal of Internal Medicine 2006;21(1):79-82
Hemobilia, in patients with the diagnosis of polyarteritis nodosa, is rare at clinical presentation and has a grave prognosis. We describe a case of massive hemobilia, due to aneurysmal rupture, in a patient with polyarteritis nodosa. A 39-year-old man was admitted to the hospital with upper abdominal pain. The patient had a history of partial small bowel resection, for intestinal infarction, about 5 years prior to this presentation. Abdominal computed tomography demonstrated multiple high attenuation areas in the bile duct and gallbladder. Hemobilia with blood seepage was visualized on endoscopic retrograde cholangiopancreatography; this bleeding stopped spontaneously. The following day, the patient developed a massive gastrointestinal bleed with resultant hypovolemic shock. Emergent hepatic angiogram revealed multiple microaneurysms; a communication was identified between a branch of the left hepatic artery and the bile duct. Hepatic arterial embolization was successfully performed. The underlying disease, polyarteritis nodosa, was managed with prednisolone and cyclophosphamide.
Rupture/*complications
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Polyarteritis Nodosa/*physiopathology
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Male
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Humans
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Hepatic Artery/*pathology
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Hemobilia/diagnosis/*etiology
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*Embolization, Therapeutic
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Aneurysm, Ruptured/*complications/therapy
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Adult
3.Cutaneous Polyarteritis Nodosa Presented with Digital Gangrene: A Case Report.
Seung Won CHOI ; Sogu LEW ; Sung Do CHO ; Hee Jeong CHA ; Eun A EUM ; Hyun Chul JUNG ; Jae Hoo PARK
Journal of Korean Medical Science 2006;21(2):371-373
Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Vasodilator Agents/therapeutic use
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Skin Diseases, Vascular/*complications/drug therapy/pathology
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Polyarteritis Nodosa/*complications/drug therapy/pathology
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Humans
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Gangrene/*etiology/surgery
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Fingers
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Female
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Amputation
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Alprostadil/therapeutic use
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Adult
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Adrenal Cortex Hormones/therapeutic use