両側性微小腎動脈りゅうの破裂をきたした結節性多発動脈炎の１例

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  • A case of periarteritis nodosa causing rupture of bilateral renal microaneurysms.

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Polyarteritis nodosa (PN) is a rare vasculitic syndrome that involves medium-sized and small mucular arteries. Recently we experienced a case of PN causing rupture of bilateral renal microaneurysms.<br> A 65-year-old man was admitted to the hospital because of sudden onset of right flank pain. With a diagnosis of right renal hemorrhage based on CT, we perfomed an angiogaphy. It visualized multiple microaneurysms in the right kidney, but there was no leakage of a contrast medium. So a coservative therapy was choosed. Just one week after admission, however, the patient suddenly complained of an abdominal pain and developed shock. On an enhanced CT scan and an angiography, we found that a small aneurysm on the dorsal branch of left renal artery ruptured. So Transcatheter arterial embolization (TAE) was successfully performed to the dorsal branch. There after a neuron biopsy performed with a suspicion of PN revealed vasulitic neuropathy. Consequently PN was diagnosed from clinical, angiographical and biopsy findings.

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