Unusual presentation of polyarteritis nodosa

We describe an unusual presentation of a localized form of polyarteritis nodosa (PAN) manifested by acute onset of severe calf pain. Biopsies of the gastrocnemius muscle and fascia revealed an acute necrotizing arteritis with fasciitis. The lumens of affected vessels were occluded by thrombi. PAN lo...

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Bibliographic Details
Published in:Journal of rheumatology 2001-04, Vol.28 (4), p.871-873
Main Authors: HALL, Charles, MONGEY, Anne-Barbara
Format: Article
Language:English
Subjects:
Antibodies, Anticardiolipin - analysis
Biological and medical sciences
Fasciitis - etiology
Fasciitis - pathology
Fasciitis - physiopathology
Humans
Leg
Male
Medical sciences
Middle Aged
Muscle, Skeletal - blood supply
Pain - physiopathology
Polyarteritis Nodosa - complications
Polyarteritis Nodosa - immunology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Thrombosis - etiology
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Summary:We describe an unusual presentation of a localized form of polyarteritis nodosa (PAN) manifested by acute onset of severe calf pain. Biopsies of the gastrocnemius muscle and fascia revealed an acute necrotizing arteritis with fasciitis. The lumens of affected vessels were occluded by thrombi. PAN localized to calf muscles is extremely rare. To our knowledge this is the first report of evidence of fascial involvement believed to contribute to the severity of the clinical features of PAN. The occurrence of multiple intraluminal thrombi in conjunction with anticardiolipin antibodies suggested the possibility of a coexisting coagulopathy, and they were also likely contributors to the severity of the pain.
ISSN:0315-162X
1499-2752