From the Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ.
Clin Nucl Med. 2024 Dec 1;49(12):e682-e684. doi: 10.1097/RLU.0000000000005517. Epub 2024 Oct 24.
A 61-year-old man with a medical history of human immunodeficiency virus well controlled on antiretroviral therapy presented for distal sensorimotor symptoms, fatigue, and recurrent fevers. Erythrocyte sedimentation rate and C-reactive protein were both elevated. Antineutrophilic cytoplasmic antibody and antinuclear antibodies were negative. Neurologic imaging workup was unremarkable. 18 F-FDG PET/CT, which was crucial for diagnosis, demonstrated pathological tracer activity throughout the medium-sized vessels with sparing of the aorta. In view of presentation, comorbidities, and imaging findings, polyarteritis nodosa was diagnosed. The patient was treated appropriately with steroids and cyclophosphamide with significant symptomatic improvement.
一位 61 岁男性,有人类免疫缺陷病毒病史,经抗逆转录病毒治疗后得到很好的控制,出现了远段感觉运动症状、疲劳和反复发热。红细胞沉降率和 C 反应蛋白均升高。抗中性粒细胞胞浆抗体和抗核抗体阴性。神经影像学检查无明显异常。18F-FDG PET/CT 对诊断至关重要,显示中等大小血管的病理性示踪剂活性,主动脉不受累。鉴于临床表现、合并症和影像学发现,诊断为结节性多动脉炎。患者接受了类固醇和环磷酰胺治疗,症状明显改善。