title: Spontaneous bilateral renal aneurysm rupture secondary to Polyarteritis Nodosa in a patient with chronic myelomonocytic leukaemia: A case report study.
abstract: BACKGROUND
  Polyarteritis Nodosa (PAN) is a systemic vasculitis affecting small and medium size arteries resulting in microaneurysms formation. Bilateral renal aneurysm rupture is a rare and life threatening complication. Although uncommon, PAN has been associated with chronic myelomonocytic leukaemia (CMML).
  
  
  METHODS
  We report a case of a 77-year-old female with a known CMML, presented to hospital with abdominal pain. Left initially and right renal microaneurym ruptures were shown in CT scan within one-week interval. Microaneurysms were treated with embolization with microcoils. A diagnosis of PAN was made and treated with successful outcome with steroids, cyclophosphamide.
  
  
  CONCLUSIONS
  Spontaneous bilateral renal haemorrhage as the initial manifestation of PAN in association with CMML is a rare condition and it can be associated in delays in diagnosis and treatment. Clinicians should be aware of this possible complication in their daily clinical practice.
authors.affiliation: John Farman ICU, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: christiana.georgiou@doctors.org.uk.
authors.forename: Christiana
authors.initials: C
authors.lastname: Georgiou
authors.affiliation: Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: mkrokidis@hotmail.com.
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Krokidis
authors.affiliation: John Farman ICU, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: drnelworthy@hotmail.co.uk.
authors.forename: Natasha
authors.initials: N
authors.lastname: Elworthy
authors.affiliation: John Farman ICU, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: stdimop@gmail.com.
authors.forename: Stavros
authors.initials: S
authors.lastname: Dimopoulos
keywords: Bilateral renal aneurysm; Chronic myelomonocytic leukaemia; Polyarteritis Nodosa