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Correspondence
Polyarteritis nodosa complicated by thrombotic thrombocytopenic purpura
  1. S YAMASAKI,
  2. M TOMINAGA,
  3. A KAWAKAMI,
  4. K MIGITA,
  5. Y KAWABE,
  6. K IZUMINO,
  7. K EGUCHI
  1. T TSUCHIYA,
  2. I SHIMOKAWA
  1. First Department of Internal Medicine
  2. Nagasaki University School of Medicine
  3. Nagasaki, Japan
  4. First Department of Pathology
  5. Nagasaki University School of Medicine
  1. Dr K Eguchi, First Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto 1–7–1, Nagasaki 852–8501, Japan eguchi{at}net.nagasaki-u.ac.jp

https://doi.org/10.1136/ard.60.5.541

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    A 56 year old woman was diagnosed with polyarteritis nodosa (PAN) in June 1998 based on the presence of fibrinoid necrosis and infiltration of polymorphonuclear cells into medium and small sized arteries on a skin biopsy specimen. She presented with erythema on her arms and legs, with fever and body weight loss. Tender masses were palpable on her right abdomen. Small erythematous lesions and livedo reticularis were seen on the arms and legs.

    Laboratory investigation on admission disclosed anaemia (haemoglobin 73 g/l) and leucocytosis (22.5×109/l) consisting mainly of neutrophils (85%). Creatinine clearance was 39 ml/min. Serological examination showed raised levels of C reactive protein (88.6 mg/l). Serological tests for syphilis, hepatitis B virus antigen, and antibody for hepatitis C virus were negative. …

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