title: Acute cholecystitis at initial presentation of polyarteritis nodosa.
abstract: Polyarteritis nodosa (PAN) is a systemic vasculitis of unknown etiology. Although gastrointestinal involvement may be seen in half of the cases of PAN, vasculitis of the gallbladder at the disease onset is a rare presentation. We report a case of a 48-year-old man who was admitted due to acute cholecystitis. He had complained of myalgia, fever and weight loss for about one month prior to admission. At physical examination, mild hypertension and calf pain were noted. He underwent a cholecystectomy; histopathological evaluation disclosed necrotizing vasculitis suggestive of PAN. We emphasize that cholecystitis may be part of the initial presentation of systemic vasculitis.
authors.affiliation: Disciplina de Reumatologia, Departamento de Clínica Médica, FCM/UNICAMP, State University of Campinas, Sao Paulo, Brazil. SRMFER@uol.com.br
authors.forename: Sandra Regina Muchinechi
authors.initials: SR
authors.lastname: Fernandes
authors.forename: Adil Muhib
authors.initials: AM
authors.lastname: Samara
authors.forename: Eduardo Paiva
authors.initials: EP
authors.lastname: Magalhães
authors.forename: Zoraida
authors.initials: Z
authors.lastname: Sachetto
authors.forename: Konradin
authors.initials: K
authors.lastname: Metze
mesh_terms: D041881:Cholecystitis, Acute / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005704:Gallbladder / Q000473:pathology* / Q000601:surgery; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011241:Prednisone