A Case of Polyarteritis Nodosa Mimicking Systemic Lupus Erythematosus

Kwang Hoon Lee; Dong Hyuk Nam; Hye Won Lee; Tae Hyun Ryu; Chan Hee Lee; Soo Kon Lee

doi:10.4078/jkra.2007.14.4.427

Journal List > J Korean Rheum Assoc > v.14(4) > 1003597

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Nam, Lee, Ryu, Lee, and Lee: A Case of Polyarteritis Nodosa Mimicking Systemic Lupus Erythematosus

Original Article

J Korean Rheum Assoc 2007;14(4):427-430.

Published online: 23 December 2007

DOI: https://doi.org/10.4078/jkra.2007.14.4.427

A Case of Polyarteritis Nodosa Mimicking Systemic Lupus Erythematosus

Kwang Hoon Lee, M.D., Dong Hyuk Nam, M.D.^∗, Hye Won Lee, M.D., Tae Hyun Ryu, M.D.^∗, Chan Hee Lee, M.D.^∗, Soo Kon Lee, M.D.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

^∗Division of Rheumatology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

Received 19 October 200729 October 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis involving multiple organ system. Systemic lupus erythematousus (SLE) also presented as a vasculitic symptoms. So, systemic vasculitis and SLE share some clinical features. We report a case of polyarteritis nodosa mimicking SLE. A 45-year-old woman was admitted due to oliguria. She diagnosed SLE because of pericardial effusion, hemolytic anemia, proteinuria, hematuria, and positivity of anti-dsDNA antibody. But she re-diagnosed as PAN through renal angiography and renal biopsy afterwards. She was treated with high dose steroid, cyclophosphamide, and anti-TNF-alpha antibody, but didn't respond those therapies.

Keywords: Polyarteritis nodosa, Systemic lupus erythematosus, Vasculitis

REFERENCES

1). Vivancos J., Soler-Carrillo J., Ara-del Rey J., Font J. Development of polyarteritis nodosa in the course of inactive systemic lupus erythematosus. Lupus. 1995. 4:494–5.

2). D'cruz D., Cervera R., 이cay AA., Ahmed T., Font J., Hughes GR. Systemic lupus erythematosus evolving into systemic vasculitis: a report of five cases. Br J Rheumatol. 1993. 32:154–7.

3). Mandell BF., Hoffman GS. Differentiating the vasculitides. Rheum Dis Clin North Am. 1994. 20:409–42.

4). Watts RA., Jolliffe VA., Carruthers DM., Lockwood M., Scott DGI. Effect of classification on the incidence of polyarteritis nodosa and microscopic polyangiitis. Arthritis Rheum. 1996. 39:1208–12.

5). Hunder GG., Arend WP., Bloch DA. The American College of Rheumatology 1990 criteria for the classification of vasculitis. Arthritis Rheum. 1990. 33:1065–7.

6). Bae YD., Choi HJ., Lee JC., Park JJ., Lee YJ., Lee EB, et al. Clinical features of polyarteritis nodosa in Korea. J Korean Med Sci. 2006. 21:591–5.

7). Heron E., Fiessinger JN., Guillevin L. Polyarteritis nodosa presenting as acute leg ischemia. J Rheumatol. 2003. 30:1344–6.

8). Al-Bishri J., le Riche N., Pope JE. Refractory polyarteritis nodosa successfully treated with infliximab. J Rheumatol. 2005. 32:1371–3.

Fig. 1.

Renal biopsy shows extensive interstitial fibrosis and lymphoplasmacytic infiltration associated with tubular atrophy (H&E stain, x 100).

Fig. 2.

Angiogram shows multiple small aneurysms (arrow) in branches of right renal artery.

TOOLS

Similar articles