Polyarteritis nodosa (PAN)

Case contributed by A.Prof Frank Gaillard

Presentation

20 year old woman with increasing abdominal pain.

DSA (angiography)

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Case Discussion

Right sided common femoral artery puncture and 5 French sheath were introduced. Non selective angiography was followed by selective angiogram of the left and right renal arteries, common hepatic artery and SMA using a 5 French C2 catheter. 

Both kidneys demonstrate beading and numerous microaneurysms affecting the segmental, interlobar, and arcuate vessels.

Similar changes are seen affecting the intrahepatic vessels with a few small microaneurysms noted. 

The proximal branches of the SMA appears normal; however there are no normal straight arteries from the jejunal arteries and lack of normal anastomotic arcades and loops.   This is associated with multiple microaneurysms.  The colic branches have more normal appearances though there are also scattered microaneurysms present.

Impression

Features are consistent with polyarteritis nodosa (PAN)

Follow-up

Despite very suggestive radiological features, muscle and renal biopsies were negative. Patient was treated presumptively, and has had a number of recurrent episodes. Long term followup unknown. 

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Case information

rID: 12791
Case created: 11th Jan 2011
Last edited: 15th Nov 2015
Inclusion in quiz mode: Included

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