title: A case of polyarteritis nodosa associated with cytomegalovirus infection.
abstract: A 77-year-old man suffering from prolonged fever of unknown origin and bilateral leg edema was referred to our hospital. On physical examination, he had fever, general fatigue, bilateral lower leg edema, and muscle weakness of the right upper extremity and left lower extremity. Neurological examination indicated motor and sensory disturbance. Electromyography revealed mononeuritis multiplex and myopathy. A biopsy of the left biceps muscle indicated necrotizing vasculitis with fibrinoid necrosis. Considering all the data together, he was diagnosed as having polyarteritis nodosa (PAN) and concurrent active cytomegalovirus (CMV) infection. His symptoms improved promptly on treatment with 50 mg of prednisolone. This case emphasizes the importance of CMV infection as one of possible etiologies of PAN and reports a therapeutic strategy for this syndrome.
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan ; Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Kouchi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Sato
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kamono
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Taoda
authors.affiliation: Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Iijima
authors.affiliation: Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mizuma
authors.affiliation: Department of Neurology, National Hakone Hospital, Odawara 250-0032, Japan.
authors.forename: Ruriko
authors.initials: R
authors.lastname: Kitao
authors.affiliation: Department of Neurology, National Hakone Hospital, Odawara 250-0032, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Mihara
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ozawa
authors.affiliation: Department of Neurology, National Hakone Hospital, Odawara 250-0032, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Ishihara
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takagi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara 259-1193, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki