1 Polyarteritis nodosa.
2 Systemic lupus erythematosus.
3 Wegener’s granulomatosis.
4 Mixed cryoglobulinemia.
Wednesday, March 9, 2011
A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs for last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side.
1 Polyarteritis nodosa.
2 Systemic lupus erythematosus.
3 Wegener’s granulomatosis.
4 Mixed cryoglobulinemia.
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ans - 1.Polyarteritis nodosa,In PAN, there is development of digital infarcts even in the presence of good peripheral pulses. Hypertension is due to involvement of renal arteries.
ReplyDeleteESR elevated
patient is said to have polyarteritis nodosa if he or she has 3 of the 10 following signs known as the 1990 ACR (American College of Rheumatology)[5] criteria:
• Weight loss greater than/equal to 4.5 kg.
• Livedo reticularis (a mottled purplish skin discoloration over the extremities or torso).
• Testicular pain or tenderness. (occasionally, a site biopsied for diagnosis).
• Muscle pain, weakness, or leg tenderness.
• Nerve disease (either single or multiple).
• Diastolic blood pressure greater than 90mmHg (high blood pressure).
• Elevated kidney blood tests (BUN greater than 40 mg/dl or creatinine greater than 1.5 mg/dl).
• Hepatitis B virus tests positive (for surface antigen or antibody).
• Arteriogram (angiogram) showing the arteries that are dilated (aneurysms) or constricted by the blood vessel inflammation.
• Biopsy of tissue showing the arteritis (typically inflamed arteries). [6] Sural nerve is a frequent location for the biopsy