Oiwa Hiroshi, Taniguchi Kohei, Miyoshi Natsuki, Sasaki Keiko, Ichimura Kouichi, Kubota Tetsushi, Sato Daisuke
Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Japan.
Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Japan.
Intern Med. 2019 Oct 15;58(20):3051-3055. doi: 10.2169/internalmedicine.2802-19. Epub 2019 Jun 27.
A 45-year-old man was admitted with acute abdominal pain and eosinophilia. Abdominal computed tomography revealed thickness of the ascending and transverse colon with decreased contrast enhancement and a small amount of ascites. In an emergency operation, the necrotic colon was resected. Histopathology showed subserous medium-sized arteritis with abundant eosinophil infiltrates and thrombosis in the portal vein branches. He was diagnosed with polyarteritis nodosa (PAN), and immunosuppressive therapy improved his condition. Two years later, the disease recurred with ischemic cutaneous lesions and marked eosinophilia. Our experience suggests that marked eosinophilia in PAN may imply severe organ involvement, including gastrointestinal necrosis, as well as the association of venous thrombosis.