Article Text

Download PDFPDF
Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach
  1. M Fraenkel-Rubin,
  2. D Ergas,
  3. Z M Sthoeger
  1. Department of Medicine “B”, Kaplan Medical Centre, Rehovot, affiliated to the Hebrew University Hadassah Medical School, Jerusalem, Israel
  1. Correspondence to:
    Dr Z M Sthoeger, Department of Internal Medicine “B”, Kaplan Medical Centre, Rehovot 76100, Israel;
    sthoeger{at}inter.net.il

Abstract

Background: Polyarteritis nodosa (PAN) is a multisystem necrotising small and medium sized vasculitis that when left untreated carries a grave prognosis, with a five year survival of 10–15%. Prolonged immunosuppressive treatment with cyclophosphamide and steroids leads to high remission rates while carrying the risk of life threatening complications. The diagnostic and therapeutic approach for patients with isolated genital tract PAN is not well defined.

Objective: To present the management and follow up of two patients with limited PAN localised to the male and female reproductive system.

Case reports: A 26 year old man presented with an “acute scrotum”. He was afebrile and had no other sign or symptom. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, liver and renal function tests, C reactive protein, antinuclear antibody, cryoglobulins, complement levels, antineutrophil cytoplasmic antibodies, and hepatitis B surface antigen, were all normal. His left testis was excised. Histopathology disclosed PAN of medium sized arteries with testicular infarction but no signs of torsion or infection. The other patient was a 51 year old woman who had had a total hysterectomy for a uterine myoma; incidentally PAN of the uterus and fallopian tubes was discovered. Neither patient received any immunosuppressive treatment after surgical removal of the affected organ. On prolonged follow up (clinical and laboratory evaluation) both patients are healthy with no sign of local recurrence or systemic PAN.

  • polyarteritis nodosa
  • reproductive system
  • Birmingham vasculitis activity score
  • treatment
  • ANCA, antineutrophil cytoplasmic antibodies
  • BVAS, Birmingham vasculitis activity score
  • CRP, C reactive protein
  • ESR, erythrocyte sedimentation rate
  • HBsAg, hepatitis B surface antigen
  • PAN, polyarteritis nodosa
  • RF, rheumatoid factor
  • VDRL, Venereal Disease Research Laboratory

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes