J Korean Rheum Assoc.  2007 Dec;14(4):427-430.

A Case of Polyarteritis Nodosa Mimicking Systemic Lupus Erythematosus

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Division of Rheumatology, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. chanheell@paran.com

Abstract

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis involving multiple organ system. Systemic lupus erythematousus (SLE) also presented as a vasculitic symptoms. So, systemic vasculitis and SLE share some clinical features. We report a case of polyarteritis nodosa mimicking SLE. A 45-year-old woman was admitted due to oliguria. She diagnosed SLE because of pericardial effusion, hemolytic anemia, proteinuria, hematuria, and positivity of anti-dsDNA antibody. But she re-diagnosed as PAN through renal angiography and renal biopsy afterwards. She was treated with high dose steroid, cyclophosphamide, and anti-TNF-alpha antibody, but didn't respond those therapies.

Keyword

Polyarteritis nodosa; Systemic lupus erythematosus; Vasculitis

MeSH Terms

Anemia, Hemolytic
Angiography
Biopsy
Cyclophosphamide
Female
Hematuria
Humans
Lupus Erythematosus, Systemic*
Middle Aged
Oliguria
Pericardial Effusion
Polyarteritis Nodosa*
Proteinuria
Systemic Vasculitis
Vasculitis
Cyclophosphamide

Figure

  • Fig. 1. Renal biopsy shows extensive interstitial fibrosis and lymphoplasmacytic infiltration associated with tubular atrophy (H&E stain, x 100).

  • Fig. 2. Angiogram shows multiple small aneurysms (arrow) in branches of right renal artery.


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