Systemic polyarteritis nodosa associated with acute Epstein-Barr virus infection.
Polyarteritis nodosa (PAN) is a rare cause of systemic vasculitis in children, affecting medium and small-sized arteries. We report on a patient who presented with prolonged fever, shock, acute renal failure with nephrotic range proteinuria, hypertension, and sudden deterioration of consciousness. Cranial tomography revealed a left extensive hemorrhagic lesion. Renal biopsy revealed a large fibrinoid necrosis lesion consistent with PAN. Epstein-Barr virus (EBV) infection was confirmed by real-time polymerase chain reaction (RT-PCR) detection of EBV DNA. The patient was successfully treated with oral prednisolone and intravenous pulse of cyclophosphamide. To our knowledge, this is the first reported case of c-PAN related to active EBV infection.
Caldeira
Teresa
T
Pediatric Intensive Care Unit, UAG-MC, Hospital S. João, Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal. caldeira.teresa@gmail.com
Meireles
Carla
C
Cunha
Francisco
F
Valbuena
Carmen
C
Aparício
José
J
Ribeiro
Augusto
A
D000208:Acute Disease; D001706:Biopsy; D002543:Cerebral Hemorrhage / Q000150:complications; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis; D004854:Herpesvirus 4, Human / Q000378:metabolism; D006801:Humans; D006973:Hypertension; D007668:Kidney / Q000473:pathology; D008297:Male; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000175:diagnosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome