Spontaneous renal laceration as the presenting feature of polyarteritis nodosa in a patient with familial Mediterranean fever after hepatitis A infection.
We report a life-threatening spontaneous renal laceration with no history of bleeding diathesis or any trauma in a patient with FMF after acute hepatitis A virus (HAV) infection. Right nephrectomy was inevitable and histological investigation of the removed right kidney revealed a polyarterits nodosa (PAN). This case underlines the possibility that simultaneous PAN and immunsupressive treatment besides colchicine should be considered for patients with FMF. Also, patients with FMF who are not immune may be vaccinated for HAV which could be a predisposing mechanism for vasculitic hemorrhage.
Candan
Ferhan
F
Department of Internal Medicine, School of Medicine of Cumhuriyet University, Sivas, Turkey, 58140. fcandan@cumhuriyet.edu.tr
Ayan
Semih
S
Tas
Fikret
F
Gökce
Gökhan
G
Elagoz
Sahande
S
D000293:Adolescent; D003078:Colchicine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D010505:Familial Mediterranean Fever / Q000150:complications / Q000473:pathology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006406:Hematoma / Q000473:pathology* / Q000601:surgery; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology*; D006506:Hepatitis A / Q000150:complications / Q000473:pathology*; D017957:Hepatitis A Virus, Human / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D010488:Polyarteritis Nodosa / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D003078:Colchicine