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2016 ; 2016
(ä): 7987081
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A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis
Treated Successfully with Tocilizumab and Cyclophosphamide
#MMPMID27018080
Watanabe K
; Rajderkar DA
; Modica RF
Case Rep Pediatr
2016[]; 2016
(ä): 7987081
PMID27018080
show ga
Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving
small- and medium-sized muscular arteries characterized by aneurysmal dilatations
involving the vessel wall. Aneurysms associated with polyarteritis nodosa are
common in visceral arteries; however intracranial aneurysms have also been
reported and can be associated with central nervous system symptoms, significant
morbidity, and mortality. To our knowledge extracranial involvement of the
vertebral arteries has not been reported but has the potential to be deleterious
due to fact that they supply the central nervous system vasculature. We present a
case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with
extracranial vessel involvement of his vertebral arteries. After thorough
diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance
Imaging/Angiography, and Computed Tomography Angiography, he was noted to have
vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis,
and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated
with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in
improvement of his inflammatory markers, radiographic findings, and physical
symptoms after treatment. To the authors' knowledge, this is the first report of
vertebral artery vasculitis in polyarteritis nodosa as well as successful
treatment of the condition using the combination cyclophosphamide and tocilizumab
for this condition.