title: Central nervous system involvement in a child with polyarteritis nodosa and severe atopic dermatitis.
abstract: Polyarteritis nodosa is a diffuse vasculitis of small- and medium-sized muscular arteries that can involve the vessels of one or several organ systems. We report an 11-year-old boy with severe atopic dermatitis further complicated with erythroderma and cerebellar symptoms. Laboratory studies showed negative antinuclear antibodies and antineutrophil cytoplasmic antibodies; increased serum complement, IgG cryoglobulins 96.8 mg/dL (0-80) and serum IgG 2,160 mg/dL (613-1,295), and positive alpha-cardiolipin test. The IgE value was high. Skin prick tests and RAST were positive for dust mites and casein. The viral profile was negative. Imaging studies disclosed tortuousity in the vessels and ischemic infarction in the cerebellum and thalamus. A diagnosis of polyarteritis nodosa with central nervous system involvement was made. The patient improved with immunosuppressive therapy and thalidomide. Currently, the patient is controlled and in a rehabilitation program. Other cases of polyarteritis nodosa associated with atopic dermatitis have not been reported.
authors.affiliation: Department of Pediatric Allergy and Immunology, Instituto Nacional de Pediatría, México City, Mexico.
authors.forename: Blanca
authors.initials: B
authors.lastname: Morfín-Maciel
authors.forename: Alejandra
authors.initials: A
authors.lastname: Medina
authors.forename: Francisco
authors.initials: F
authors.lastname: Espinosa Rosales
authors.forename: Renato
authors.initials: R
authors.lastname: Berrón
authors.forename: José
authors.initials: J
authors.lastname: Huerta López
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D002545:Brain Ischemia / Q000209:etiology*; D002531:Cerebellum / Q000098:blood supply; D002544:Cerebral Infarction / Q000209:etiology*; D002648:Child; D003876:Dermatitis, Atopic / Q000150:complications* / Q000188:drug therapy; D005512:Food Hypersensitivity / Q000150:complications; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications; D010291:Paresis / Q000209:etiology; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000188:drug therapy; D012874:Skin Diseases, Infectious / Q000150:complications; D013788:Thalamus / Q000098:blood supply
chemical_list: D017153:Antibodies, Anticardiolipin; D007166:Immunosuppressive Agents