YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==PERIARTERITIS, OR PAN== 1 AUTHOR Pechere M AUTHOR Helfer C AUTHOR Laurencet FL TITLE [Periodic disease and periarteritis nodosa in the same patient: coincidence?] SOURCE Schweiz Med Wochenschr; VOL 121, ISS 33, 1991, P1166-8 ABSTRACT Familial Mediterranean fever (FMF) chiefly affects patients of Arabic, Jewish, Armenian or Turkish origin and takes the form of recurrent episodes of peritonitis, arthritis or pleurisy. Periarteritis nodosa (PAN) is a vasculitis affecting elderly people and manifested by a general deterioration, unexplained fever and peripheral neuropathy or muscular weakness. We describe a patient presenting both diseases. Ours is the seventh reported case associating these two affections. This association was suspected by SACHS and co-workers who discovered an increased frequency of PAN in patients with FMF compared to the expected rate for the whole population (7). These observations warrant a search for PAN in young patients affected by FMF and showing signs of vasculitis. 2 AUTHOR Turki S AUTHOR Guillevin L AUTHOR Dallot A AUTHOR Jarrousse B AUTHOR Vernier I AUTHOR Laroche L AUTHOR Pourrat J AUTHOR Amouroux J TITLE [Nodular and granulomatous form of periarteritis nodosa caused by the hepatitis B virus] SOURCE Ann Dermatol Venereol; VOL 121, ISS 4, 1994, P325-7 ABSTRACT Polyarteritis nodosa (PAN) is, in rare cases, associated with subcutaneous nodules and pathology does not usually show the presence of peri and extravascular granulomas. When present in patients with hepatitis B virus (HBV) related PAN these facts demonstrate that classification of PAN is not homogeneous. CASE REPORT. A patient infected by HBV developed a PAN demonstrated by clinical symptoms and pathology. The disease was characterized by the presence of subcutaneous nodules and histologically by peri- and extra-vascular granuloma which surrounded necrosis of medium-sized vessels. Outcome was also unusual in the patient who did not respond to the association of plasma exchanges and antiviral agents and was only slightly improved by steroids and cyclophosphamide. COMMENTS. HBV-related PAN is considered to be an immune complex disorder. In the present case report granuloma were present as observed in Churg Strauss syndrome or Wegener's granulomatosis which are the consequence of other pathogenetic mechanisms as anticytoplasmic neutrophil antibodies (ANCA). This case reports underlines the heterogeneity of the PAN group of vasculitis and the probable role for various pathogenetic mechanisms. 1 AUTHOR Machet L AUTHOR Vincent O AUTHOR Machet MC AUTHOR Barruet K AUTHOR Vaillant L AUTHOR Lorette G TITLE [Cutaneous periarteritis nodosa resistant to combined corticosteroids and immunosuppressive agents. Efficacy of treatment with intravenous immunoglobulins] SOURCE Ann Dermatol Venereol; VOL 122, ISS 11-12, 1995, P769-72 ABSTRACT INTRODUCTION: Cutaneous polyarteritis nodosa is a subset of polyarteritis nodosa (PAN) characterized by a good prognosis because of the absence of severe visceral involvement. Dapsone, colchicin, non steroidal anti-inflammatory drugs are the first line treatments of cutaneous PAN. Corticosteroids are an alternative therapy. CASE-REPORT: A case of cutaneous PAN followed for 6 years is reported. Dapsone, colchicin, corticosteroid and cyclophosphamide have failed to control cutaneous lesions. Intravenous immunoglobulins 400 mg/kg/d five day monthly for 5 months was successful, but a cutaneous relapse occurred 3 months later which was another time controlled with intravenous immunoglobulins. DISCUSSION: Some cases of necrotizing vasculitis have been treated with intravenous immunoglobulins. This is the first reported case of cutaneous PAN treated with intravenous immunoglobulins. Because of the lack of controlled studies, the indications of intravenous immunoglobulins in vasculitis are restricted to those resistant to corticosteroids and immunosuppressive therapy. 5 AUTHOR Glasson P AUTHOR Stamenkovic I AUTHOR Leski M TITLE [Isolated renal involvement in periarteritis nodosa] SOURCE Schweiz Med Wochenschr; VOL 112, ISS 3, 1982, P93-4 ABSTRACT Periarteritis nodosa (PAN) is a disease involving the kidneys in 70% of cases but always affecting other organs. Initial presentation with acute renal failure (ARF) and high blood pressure (HBP) is unusual. In two patients presenting those two features without any clinical or biochemical signs of other organ involvements, diagnosis of PAN was based on the presence of microaneurysms on renal angiograms. Combined immunosuppressive and steroid treatment resulted in control of blood pressure of both patients and improvement of renal function in one. ARF associated with HBP without evidence of other organ involvements is consistent with the diagnosis of PAN. In this clinical setting, renal angiography should be performed to confirm the diagnosis and establish the appropriate therapy.