Polyarteritis nodosa

Abstract

The first description of polyarteritis nodosa (PAN) was in 1852 by Karl Rokitansky, a pathologist at the University of Vienna. The initial report describes a 23-year-old man who had a 5-day history of fever and diarrhea. Since then, the definition of PAN has evolved. The currently accepted definition of PAN comes from the 2012 Chapel Hill Conference, which classified PAN as a necrotizing arteritis not associated with antineutrophil cytoplasmic antibodies of medium or small arteries without glomerulonephritis or vasculitis in arterioles, capillaries, or venules.

Keywords: Polyaarteritis; imaging technique; nodosa; treatment.

Figure 1

Twenty-seven year-old male who presented with headache, hypertension, and renal insufficiency. A left renal artery angiogram demonstrates multiple small aneurysms (red arrows) with segmental/sub-segmental irregular narrowing (yellow arrows).

Figure 2

54 year-old woman with non-healing ulcerations on her legs and distal gangrene. A left renal artery angiogram demonstrates small aneurysms (red arrows).

Figure 3

60 year old male who developed acute onset of burning paresthesias in his toes and feet followed by blistering ischemic lesions involving his toes with skin breakdown, splinter hemorrhages involving his fingers, and swelling involving his right third finger. ANCA serologies were negative. Angiogram of both hands demonstrates segmental narrowing and micro-aneurysms (red arrows).

Figure 4

Seventy-nine year-old female with dissection (red arrow) of her superior mesenteric artery on sagittal CT (A) and axial CT (B) with irregular narrowing (red arrow) of renal arteries (C).