Critical Limb Threatening Ischemia Due to Severe Polyarteritis Nodosa
A delayed diagnosis of polyarteritis nodosa may lead to critical limb-threatening ischemia (CLTI). A 74-year-old woman presented with left-foot pain and was treated with oral vasodilators and antiplatelet agents. However, the distal ischemia progressed to CLTI, including gangrene of the fingers and toes, and bilateral foot dropping appeared because of peroneal nerve paralysis. Angiography of the extremities revealed obstruction and stenosis of medium-sized arteries. Based on the progressive distal gangrene, mononeuropathy multiplex, and pathological findings of necrotic vasculitis, polyarteritis nodosa was diagnosed, and the patient's condition improved. A biopsy and neurological examination are essential for the appropriate diagnosis of PAN and immediate treatment.
Authors
- Hiroto Yoneda
- Yasuhiko Nishioka (ORCID: https://orcid.org/0000-0001-6311-1654)
- Takayuki Ise (ORCID: https://orcid.org/0000-0001-6873-1609)
- Yasushi Aibara
- Kazuo Matsuyama (ORCID: https://orcid.org/0000-0002-2635-4080)
- Tetsuya Kitagawa
- Takeshi Soeki
- Keisuke Nakanishi (ORCID: https://orcid.org/0000-0002-9063-2268)
- Takuya Ishida (ORCID: https://orcid.org/0000-0002-7152-910X)
- Koji Yamaguchi (ORCID: https://orcid.org/0000-0002-8758-6598)
- Shusuke Yagi
- Hirotsugu Yamada (ORCID: https://orcid.org/0000-0003-3741-5560)
- Masaki Yamamoto (ORCID: https://orcid.org/0000-0002-9536-088X)
- Tetsuzo Wakatsuki
- I. Yagi
- Kazuki Tezuka
- Masataka Sata
Institutions
- Tokushima University Hospital (JP)
- Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers (JP)
Publication Details
- Journal
- Internal Medicine
- Published
- 2024-10-03
- DOI
- https://doi.org/10.2169/internalmedicine.4149-24
- Citations
- 1
- Primary Topic
- Vasculitis and related conditions
- Type
- article
- Field-Weighted Citation Impact
- 0.42