The "Viral" Form of Polyarteritis Nodosa (PAN)-A Distinct Entity: A Case Based Review

• Published in: Medicina (Kaunas, Lithuania) Vol. 59; no. 6; p. 1162
• Main Authors: Pașa, Victoria, Popa, Elena, Poroch, Mihaela, Cosmescu, Adriana, Bacusca, Agnes Iacinta, Slanina, Ana Maria, Ceasovschih, Alexandr, Stoica, Alexandra, Petroaie, Antoneta, Ungureanu, Monica, Popa, Andrei Emilian, Avram, Raluca Ioana, Bologa, Cristina, Poroch, Vladimir, Coman, Elena Adorata
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Abdomen; Anemia; Aneurysms; Antibiotics; Antibodies; Arthritis; Blood circulation disorders; Blood vessels; Disease; Hepatitis B; Hepatitis C; HIV; Human immunodeficiency virus; Infections; Inflammation; Ischemia; Kidneys; Laboratories; Morphology; multisystem complications; Nonsteroidal anti-inflammatory drugs; polyarteritis nodosa (PAN); Review; Skin; Surgical clinics; systemic vasculitis; Veins & arteries; Romania; polyarteritis nodosa (PAN); systemic vasculitis; inflammation; multisystem complications
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina59061162

Classic polyarteritis nodosa (PAN) is a vasculitis with systemic manifestations that is characterized by inflammatory and necrotizing lesions affecting medium and small muscular arteries, most frequently at the bifurcation of the vessels. These lesions lead to the formation of microaneurysms, hemorrhaging ruptured aneurysms, thrombosis, and, consequently, ischemia or organ infarction. : We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement. : The 44-year-old patient, in an urban environment, presented on her own in the emergency room for acute ischemia phenomena and forearm and right-hand compartment syndrome, requiring surgical decompression in the Plastic Surgery Clinic. : Significant inflammatory syndrome is noted, alongside severe normocytic hypochromic iron deficiency anemia, nitrogen retention syndrome, hyperkalemia, hepatic syndrome, and immunological disturbances: absence of cANCA, pANCA, anti Scl 70 Ac, antinuclear Ac, and anti dDNA Ac, as well as a low C3 fraction of the plasmatic complement system. The morphological aspect described in the right-hand skin biopsy correlated with the clinical data supports the diagnosis of PAN. : The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.