Question
A patient presents with melaena, normal renal function, hypertension, and mono neuritis multiplex. The most probable diagnosis is:
| A. |
Classical polyarteritis nodosa
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| B. |
Microscopic polyangiitis
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| C. |
Henoch-Schonlein purpura
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| D. |
Buerger’s disease
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Show Answer
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Correct Answer � A
Explanation
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|
Ans. A
Classical polyarteritis nodosa
PAN is characterized by segmental, transmural necrotizing inflammation of muscular arteries, most commonly at points of bifurcation.
Most commonly affected are the kidneys, skin, peripheral nerves, joints, muscles, and GI tract.
renal involvement most commonly manifests as hypertension, renal insufficiency, or hemorrhage due to microaneurysms. Glomerulonephritis is rare.
Vasculitic neuropathy (mono neuritis multiplex) refers to an anatomic pattern of peripheral neuropathy that affects two or more noncontiguous named nerves simultaneously or sequentially
Vasculitic causes of mononeuritis multiplex
Polyarteritis nodosa
Churg-Strauss syndrome
Wegener’s syndrome
Hypersensitivity
Cryoglobulinemia
Systemic lupus erythematosus
Rheumatoid arthritis
Sjögren’s syndrome
Chronic active hepatitis
Glomerulonephritis is very common in microscopic polyangiitis, and pulmonary capillaritis often occur.
Buerger disease / Thromboangiitis obliterans (TAO), an inflammatory vasculopathy. It characteristically affects small and medium-sized arteries as well as veins of the upper and lower extremities.
