Journals / art / 2019 / Cilt: 34 - Sayı: 3

A Child Diagnosed With Treatment-Resistant Polyarteritis Nodosa: Can the Clinical Diagnosis be Different?

Journal
art
Pages
338–342
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In this case, accompanying FMF mutation was also observed.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Polyarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving the wall of small and medium sized arteries.
📊
Key Findings & Data:The histological aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas.
💡
Conclusion & Impact:In this case, accompanying FMF mutation was also observed.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Polyarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving the wall of small and medium sized arteries. The histological aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas. CECR1 (Cat Eye Syndrome Chromosome Region 1) gene mutation causing adenosine deaminase 2 (ADA2) deficiency is also associated with systemic inflammation, vasculopathy, and frequently PAN. Strokes, neurological involvement, and gastrointestinal involvement have poor prognosis in the cases with ADA2 deficiency particularly in early stage. In this article, we report a 17-year-old male patient diagnosed with PAN who had severe gastrointestinal system involvement that was resistant to intensive and conventional immunosuppressive treatment and showed a fatal course despite the emergency surgical intervention. After the patient was exitus, he was detected to have a heterozygous mutation (V276A) of familial Mediterranean fever (FMF) and also a homozygous ADA2 mutation. The aim of this article is to highlight that ADA2 deficiency may be present in treatment-resistant PAN cases who apply due to severe systemic involvement. In this case, accompanying FMF mutation was also observed.

🔖

Cite This Article

ALAYGUT, D., ALPARSLAN, C., ÖNCEL, E. P., MUTLUBAŞ, F., ÖZDEMİR, T., YAVAŞCAN, Ö., DEMİR, B. K. (2019). A Child Diagnosed With Treatment-Resistant Polyarteritis Nodosa: Can the Clinical Diagnosis be Different?. art, Cilt: 34 - Sayı: 3, 338–342. https://ajindex.com/articles/151204

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Gaspar HB, Aiuti A, Porta F, Candotti F, Hershfield MS, Notarangelo LD. How I treat ADA deficiency. Blood 2009;114:3524-32
  2. Navon Elkan P, Pierce SB, Segel R, Walsh T, Barash J, Padeh S, et al. Mutant adenosine deaminase 2 in a polyarteritis nodosa vasculopathy. N Engl J Med 2014;370:921-31
  3. Garg N, Kasapcopur O, Foster J, Barut K, Tekin A, Kızılkılıç O, et al. Novel adenosine deaminase 2 mutations in a child with a fatal vasculopathy. Eur J Pediatr 2014;173:827-30
  4. Zhou Q, Yang D, Ombrello AK, Zavialov AV, Toro C, Zavialov AV, et al. Early-onset stroke and vasculopathy associated with mutations in ADA2. N Engl J Med 2014;370:911-20
  5. De Virgilio A, Greco A, Magliulo G, Gallo A, Ruoppolo G, Conte M, et al. Polyarteritis nodosa: A contemporary overview. Autoimmun Rev 2016;15:564-70
  6. Lhote F, Cohen P, Guillevin L. Polyarteritis nodosa, microscopic polyangiitis and Churg-Strauss syndrome. Lupus 1998;7:238-58
  7. Barut K, Sahin S, Kasapcopur O. Pediatric vasculitis. Curr Opin Rheumatol 2016;28:29-38
  8. Eleftheriou D, Dillon MJ, Tullus K, Marks SD, Pilkington CA, Roebuck DJ, et al. Systemic polyarteritis nodosa in the young: a single-center experience over thirtytwo years. Arthritis Rheum 2013;65:2476-85
  9. Stone JH. Polyarteritis nodosa. JAMA 2002;288:1632-9
  10. Buldukoglu OC, Koklu S, Koklu H, Uluoglu O, Kulduk G. Intestinal perforation as the initial presentation of polyarteritis nodosa in an older adult. Geriatr Gerontol Int 2015;15:121-2
  11. Gündo¤du HZ, Kale G, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Intestinal perforation as an initial presentation of polyarteritis nodosa in an 8-year-old boy. J Pediatr Surg 1993;28:632-4
  12. Ba¤ci P, Erdamar S, Erzin Y, Karataş A, Tuncer M. A case of polyarteritis nodosa diagnosed after recurrent, multiple intestinal perforations. Turk J Gastroenterol 2009;20:71-2
  13. Asti E, Pogliani L, Tritella S, Bonavina L. Polyarteritis nodosa and acute abdomen: A role for laparoscopy? Int J Surg Case Rep 2015;17:161-3
  14. Ozen S. Mutations/polymorphisms in a monogenetic autoinflammatory disease may be susceptibility markers for certain rheumatic diseases: lessons from the bedside for the benchside. Clin Exp Rheumatol 2009;27:29-31
  15. Ozen S, Ben-Chetrit E, Bakkaloglu A, Gur H, Tinaztepe K, Calguneri M, et al. Polyarteritis nodosa in patients with Familial Mediterranean Fever (FMF): a concomitant disease or a feature of FMF? Semin Arthritis Rheum 2001;30:281-7
  16. Yalçinkaya F, Ozçakar ZB, Kasapçopur O, O