Cheng Mei-Mei, Yen Chun-Sheng, Li Chien-Ming, Chien Chih-Chiang, Kan Wei- Chih
Clin Nephrol. 2014 May;81(5):359-62. doi: 10.5414/CN107786.
A 68-year-old man presented with a spontaneous bilateral perirenal hemorrhage following a 2-month fever of unknown origin. A renal biopsy for a pathologic diagnosis seemed very risky because of the patient's bilateral perirenal hemorrhage. Therefore, we diagnosed polyarteritis nodosa using an abdominal computed tomography scan, a renal angiogram, and American College of Rheumatology criteria. The patient's multiple symptoms then responded well to the prescribed immunosuppressive regimen. This case is an uncommon presentation of polyarteritis nodosa with fever of unknown origin before a spontaneous bilateral perirenal hemorrhage.
一名68岁男性在持续2个月不明原因发热后出现自发性双侧肾周出血。由于患者双侧肾周出血，进行肾活检以明确病理诊断似乎风险极大。因此，我们依据腹部计算机断层扫描、肾血管造影以及美国风湿病学会标准诊断为结节性多动脉炎。随后，患者的多种症状对所开的免疫抑制治疗方案反应良好。该病例是结节性多动脉炎的一种罕见表现，在自发性双侧肾周出血之前伴有不明原因发热。
