title: Spontaneous bilateral perirenal hemorrhage following prolonged fever: an uncommon presentation of polyarteritis nodosa.
abstract: A 68-year-old man presented with a spontaneous bilateral perirenal hemorrhage following a 2-month fever of unknown origin. A renal biopsy for a pathologic diagnosis seemed very risky because of the patient's bilateral perirenal hemorrhage. Therefore, we diagnosed polyarteritis nodosa using an abdominal computed tomography scan, a renal angiogram, and American College of Rheumatology criteria. The patient's multiple symptoms then responded well to the prescribed immunosuppressive regimen. This case is an uncommon presentation of polyarteritis nodosa with fever of unknown origin before a spontaneous bilateral perirenal hemorrhage.
authors.forename: Mei-Mei
authors.initials: MM
authors.lastname: Cheng
authors.forename: Chun-Sheng
authors.initials: CS
authors.lastname: Yen
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Li
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chien
authors.forename: Wei- Chih
authors.initials: W
authors.lastname: Kan
mesh_terms: D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D005335:Fever of Unknown Origin / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D010488:Polyarteritis Nodosa / Q000150:complications*; D014057:Tomography, X-Ray Computed
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic