title: A case of classical polyarteritis nodosa complicated by ulcerative colitis.
abstract: Classical polyarteritis nodosa (PAN) is a term that includes patients with necrotizing inflammation of medium-sized arteries and excludes those with microscopic vessel involvement. Although gastrointestinal manifestations are not unusual in patients with classical PAN, the association with ulcerative colitis has been reported only rarely. We describe a patient with classical PAN complicated by bilateral renal artery aneurysms with subsequent rapture and perirenal hemorrhages. He was successfully treated, and the bilateral renal aneurysms resolved with steroid therapy. Two years later, the patient presented with hematochezia. Colonoscopy revealed inflamed rectal mucosa with bleeding ulcers. Histologic findings of biopsy specimens showed severe mucosal inflammation and crypt abscess. The patient was diagnosed with ulcerative colitis, and the symptoms attenuated after meselazine therapy.
authors.affiliation: Department of Gastroenterology, NHO National Nagasaki Medical Center, Nagasaki, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazato
authors.forename: Kenta
authors.initials: K
authors.lastname: Okamoto
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Saburo
authors.initials: S
authors.lastname: Shikuwa
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000188:drug therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents