Background Polyarteritis nodosa (PAN) is severe systemic vasculitis that may affect almost all systems. Rarely isolated organ involvement occurs. These cases generally have more benign course and respond well to high dose of steroids. The addition of cytotoxic drugs is controversial. PAN limited to calf muscles is extremely uncommon. Painful tenderness and swelling of dorsal calf muscles, mild fever and general signs of inflammation in blood tests are the only features of this form of vasculitis. ANCA is not obligatory positive. Muscle biopsy is the only way to make the diagnosis.
Conclusion The two herein reported cases (Table 1) of biopsy proven PAN of the calve show that the addition of single course of intravenous immunoglobulin to steroid treatment yielded rapid and stable clinical and laboratory remission with low doses of steroids from the beginning and rapid tapering off.
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