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Zahoor S, Siddique S, Mahboob HM. An unusual presentation of polyarteritis nodosa: A case report. Reumatol Clin (Engl Ed) 2022; 18:124-126. [PMID: 35153035 DOI: 10.1016/j.reumae.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/06/2020] [Indexed: 06/14/2023]
Abstract
Polyarteritis nodosa (PAN) is a rare form of vasculitis which involves medium and small sized arteries. It can involve any system of the body, but lungs are typically spared. PAN typically presents with non-specific symptoms, such as fever, weight loss and myalgias, and symptoms related to the system involved. Negative serum ANCA helps in differentiating it from other similarly presenting vasculitis and definitive diagnosis is made on histopathology. Limb ischaemia is a rare presentation as well as a rare complication of PAN. We present the case of a 28-year-old female who presented with severe lower limb ischaemia and intermittent leg claudication as initial symptoms which led to initial diagnosis of critical limb ischaemia. Later in the course of the illness she developed gastrointestinal symptoms and weight loss. She was diagnosed as having PAN based on laboratory results and histopathological evidence. Intravenous steroids halted the progress of the disease, but the patient required transmetatarsal amputation of the foot to remove dead tissue. Vasculitis like PAN, although much rarer than atherosclerotic peripheral vascular disease (PVD), should be considered as a differential diagnosis in cases of limb ischaemia in which there is lack of risk factors for PVD.
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Affiliation(s)
- Sarmad Zahoor
- King Edward Medical University, Mayo Hospital Lahore, Pakistan.
| | - Samara Siddique
- King Edward Medical University, Mayo Hospital Lahore, Pakistan
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Zahoor S, Siddique S, Mahboob HM. An unusual presentation of polyarteritis nodosa: A case report. Reumatol Clin (Engl Ed) 2020; 18:S1699-258X(20)30227-8. [PMID: 33160892 DOI: 10.1016/j.reuma.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
Polyarteritis nodosa (PAN) is a rare form of vasculitis which involves medium and small sized arteries. It can involve any system of the body, but lungs are typically spared. PAN typically presents with non-specific symptoms, such as fever, weight loss and myalgias, and symptoms related to the system involved. Negative serum ANCA helps in differentiating it from other similarly presenting vasculitis and definitive diagnosis is made on histopathology. Limb ischaemia is a rare presentation as well as a rare complication of PAN. We present the case of a 28-year-old female who presented with severe lower limb ischaemia and intermittent leg claudication as initial symptoms which led to initial diagnosis of critical limb ischaemia. Later in the course of the illness she developed gastrointestinal symptoms and weight loss. She was diagnosed as having PAN based on laboratory results and histopathological evidence. Intravenous steroids halted the progress of the disease, but the patient required transmetatarsal amputation of the foot to remove dead tissue. Vasculitis like PAN, although much rarer than atherosclerotic peripheral vascular disease (PVD), should be considered as a differential diagnosis in cases of limb ischaemia in which there is lack of risk factors for PVD.
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Affiliation(s)
- Sarmad Zahoor
- King Edward Medical University, Mayo Hospital Lahore, Pakistan.
| | - Samara Siddique
- King Edward Medical University, Mayo Hospital Lahore, Pakistan
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Panaich SS, Patel N, Agnihotri K, Arora S, Savani C, Sonani R, Patel NJ, Patel SV, Solanki S, Schreiber T, Grines C, Badheka AO. Volume-outcome relationship for peripheral endovascular interventions: a review of existing literature. Expert Rev Pharmacoecon Outcomes Res 2016; 16:103-9. [PMID: 26732517 DOI: 10.1586/14737167.2016.1138859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The incidence and prevalence of peripheral vascular disease has been increasing. When coexistent with coronary artery disease (CAD), it has shown to predict higher mortality along with poorer quality-of-life consequently leading to a marked increase in healthcare costs. Broadly, there has been an increase in utilization of endovascular techniques in the management of peripheral vascular diseases. An inverse relation between volume and outcomes has been noted in these procedures. Additionally, improved resource utilization has also been noted with higher hospital and operator volumes. This has led to proposals to regionalize these procedures to high volume hospitals. There have also been calls to introduce the idea of having a set threshold of procedures for providers. This review presents an overview of published literature on the volume-outcome relationship affecting the outcomes of peripheral endovascular procedures.
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Affiliation(s)
| | - Nilay Patel
- b Internal Medicine Department , Saint Peter's University Hospital , New Brunswick , NJ , USA
| | - Kanishk Agnihotri
- b Internal Medicine Department , Saint Peter's University Hospital , New Brunswick , NJ , USA
| | - Shilpkumar Arora
- c Internal Medicine Department , Mount Sinai St. Luke's Roosevelt Hospital , New York , NY , USA
| | - Chirag Savani
- d Epidemiology Department , New York Medical College , Valhalla , NY , USA
| | - Raj Sonani
- e Public Health Department , Emory University School of Medicine , Atlanta , GA , USA
| | - Nileshkumar J Patel
- f Cardiology Department , University of Miami Miller school of Medicine , Miami , FL , USA
| | - Samir V Patel
- g Internal Medicine Department , Western Reserve Health System , Youngstown , OH , USA
| | - Shantanu Solanki
- h Internal Medicine Department , Westchester Medical center at New York Medical College , Valhalla , NY , USA
| | | | - Cindy Grines
- i Cardiology Department , Detroit Medical Centre , Detroit , MI , USA
| | - Apurva O Badheka
- j Cardiology Department , The Everett Clinic , Everett , WA , USA
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