Kouyoumdjian J A, Fonseca M G, De Toledo R A, Centola C A
Arq Neuropsiquiatr. 1986 Jun;44(2):195-200. doi: 10.1590/s0004-282x1986000200013.
A case of polyarteritis nodosa (PAN) in a 54 year-old man is presented. The clinical picture showed a 6-month history of mixed sensorimotor distal symmetrical polyneuropathy in all limbs together with anorexia, weight loss, fatigue, arthralgia, myalgia, mild fever and hypertension. The laboratory studies showed leucocytosis, elevated ESR, positive HBsAg and presence of cryoglobulins. Selective renal, celiac and mesenteric angiography was performed by femoral approach and has showed innumerable aneurysms most of them in hepatic and renal circulation. After about two weeks death has occurred. A brief discussion is done on clinical aspects of PAN pointing out the importance of HBsAg determination on etiopathogenesis and angiographic study on diagnosis.
本文报告一例54岁男性结节性多动脉炎(PAN)病例。临床表现为四肢混合性感觉运动性远端对称性多发性神经病6个月病史,伴有厌食、体重减轻、疲劳、关节痛、肌痛、低热和高血压。实验室检查显示白细胞增多、血沉升高(ESR)、乙肝表面抗原(HBsAg)阳性和冷球蛋白血症。通过股动脉途径进行了选择性肾动脉、腹腔动脉和肠系膜动脉造影,显示无数动脉瘤,其中大多数位于肝循环和肾循环。约两周后患者死亡。对PAN的临床方面进行了简要讨论,指出了HBsAg测定在病因学中的重要性以及血管造影研究在诊断中的重要性。