Toyoda Yuko, Ozaki Ryohiko, Kishi Jun, Hanibuchi Masaki, Kinoshita Katsuhiro, Tezuka Toshifumi, Goto Hisatsugu, Ono Hiroyuki, Nagai Kojiro, Bando Yoshimi, Doi Toshio, Nishioka Yasuhiko
Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan.
Intern Med. 2016;55(21):3191-3195. doi: 10.2169/internalmedicine.55.7152. Epub 2016 Nov 1.
A 61-year-old man had hypertension with stenosis in the left renal artery. When his fever, abdominal pain, and renal dysfunction progressed, he was admitted to our hospital. He was diagnosed with polyarthritis nodosa. His renal function rapidly deteriorated despite immunosuppressive therapy. His digestive tract perforated twice, and he subsequently died. An autopsy revealed that aortic intimal sarcoma caused stenosis in multiple arteries. Both polyarteritis nodosa and aortic intimal sarcoma are very rare diseases and the diagnoses are very difficult. It is very important to consider these entities when making a differential diagnosis of vasculitis.
一名61岁男性患有高血压，伴有左肾动脉狭窄。当他出现发热、腹痛和肾功能障碍加重时，被收治入我院。他被诊断为结节性多动脉炎。尽管接受了免疫抑制治疗，他的肾功能仍迅速恶化。他的消化道两次穿孔，随后死亡。尸检显示主动脉内膜肉瘤导致多处动脉狭窄。结节性多动脉炎和主动脉内膜肉瘤都是非常罕见的疾病，诊断非常困难。在对血管炎进行鉴别诊断时，考虑这些疾病实体非常重要。
