Primary polyarteritis nodosa presenting as acute symmetric quadriplegia.
We report a case of peripheral neuropathy presenting as acute symmetric areflexic quadriplegia in the setting of a well-defined clinical, histopathologic, and angiographic diagnosis of classic polyarteritis nodosa. While it is usually easy to recognize the typical clinical presentation of necrotizing angiopathy-induced peripheral neuropathy as a mononeuritis multiplex or a distal polyneuropathy in association with a collagen vascular disease, clinicians must be equally sensitive to a number of more challenging possibilities. Acute quadriplegia similar to that seen in Guillain-Barré syndrome can be secondary to primary classic polyarteritis nodosa and the former may be the chief or even the sole manifestation of the latter.
Bosch
X
X
Internal Medicine Unit, Hospital Casa Maternitat, Corporació Sanitària Clínic, Barcelona, Spain.
Navarro
M
M
Lopez-Soto
A
A
Grau
J M
JM
Martinez-Orozco
F
F
D000368:Aged; D000792:Angiography; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D009336:Necrosis; D010488:Polyarteritis Nodosa / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D011782:Quadriplegia / Q000175:diagnosis* / Q000209:etiology; D013497:Sural Nerve / Q000098:blood supply / Q000473:pathology; D016896:Treatment Outcome
D003520:Cyclophosphamide; D011241:Prednisone