Dramatic regression of mesenteric abnormalities demonstrated on angiography following prednisolone and cyclophosphamide combination therapy in a patient with polyarteritis nodosa associated with Sjögren's syndrome.
A 63-year-old woman, who had been followed for Sjögren's syndrome, was admitted due to cryoglobulinemia, leukocytoclastic vasculitis, and mononeuritis multiplexa. In spite of the administration of 60 mg prednisolone, fecal occult blood was strongly positive. The colonoscopy showed multiple colonic ulcers, and a diagnosis of polyarteritis nodosa (PAN) was made because abdominal angiography revealed markedly serpentine and narrowed superior and inferior mesenteric arteries. After steroid pulse therapy and daily oral administration of cyclophosphamide were initiated, her symptoms improved and abdominal angiographic findings were finally normalized. Although there are only three case reports on improvements in abdominal angiographic findings of PAN in the literature, our case and previously reported cases suggest that improvements in angiographic findings may reflect a good prognosis of PAN.
Yukawa
Sonosuke
S
Department of Rheumatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. s-yukawa@med.uoeh-u.ac.jp
Tahara
Koichiro
K
Yukawa
Naoichiro
N
Shoji
Aki
A
Tsuji
Soichiro
S
Hayashi
Haeru
H
Tsuboi
Norioki
N
D000792:Angiography; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000473:pathology; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D012810:Sigmoid Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D014456:Ulcer / Q000188:drug therapy / Q000473:pathology
D003520:Cyclophosphamide; D011239:Prednisolone