Vol.18 No.4

Case Report

Dramatic regression of mesenteric abnormalities demonstrated on angiography following prednisolone and cyclophosphamide combination therapy in a patient with polyarteritis nodosa associated with Sjögren’s syndrome

Authors

Sonosuke Yukawa1,2 , Koichiro Tahara1 , Naoichiro Yukawa3 , Aki Shoji1 , Soichiro Tsuji1 , Haeru Hayashi1 , Norioki Tsuboi1

  • Department of Rheumatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
  • First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, 807-8555, Japan
  • Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Received:

8 January 2008

Accepted:

10 March 2008

Published online:

15 May 2008

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Abstract

A 63-year-old woman, who had been followed for Sjögren’s syndrome, was admitted due to cryoglobulinemia, leukocytoclastic vasculitis, and mononeuritis multiplexa. In spite of the administration of 60 mg prednisolone, fecal occult blood was strongly positive. The colonoscopy showed multiple colonic ulcers, and a diagnosis of polyarteritis nodosa (PAN) was made because abdominal angiography revealed markedly serpentine and narrowed superior and inferior mesenteric arteries. After steroid pulse therapy and daily oral administration of cyclophosphamide were initiated, her symptoms improved and abdominal angiographic findings were finally normalized. Although there are only three case reports on improvements in abdominal angiographic findings of PAN in the literature, our case and previously reported cases suggest that improvements in angiographic findings may reflect a good prognosis of PAN.

Key words

Abdominal angiography - Cyclophosphamide (CY) - Multiple colonic ulcers - Polyarteritis nodosa (PAN) - Sjögren’s syndrome (SS)