title: Spontaneous renal laceration as the presenting feature of polyarteritis nodosa in a patient with familial Mediterranean fever after hepatitis A infection.
abstract: 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.
authors.affiliation: Department of Internal Medicine, School of Medicine of Cumhuriyet University, Sivas, Turkey, 58140. fcandan@cumhuriyet.edu.tr
authors.forename: Ferhan
authors.initials: F
authors.lastname: Candan
authors.forename: Semih
authors.initials: S
authors.lastname: Ayan
authors.forename: Fikret
authors.initials: F
authors.lastname: Tas
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gökce
authors.forename: Sahande
authors.initials: S
authors.lastname: Elagoz
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D003078:Colchicine