Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa
Joint Authors
Weerarathna, Thilak
Fonseka, C. L.
De Silva, P. U. T.
Senarathna, H. M.
Perera, H. A. S.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-04-07
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Background.
Polyarteritis nodosa (PAN) is a form of necrotizing vasculitis affecting medium or small blood vessels with multiorgan involvement.
Although myalgia is a clinical feature of PAN, severe disabling myalgia as the initial presentation is rarely noted.
Case Presentation.
We present a case of 54-year-old male with recently detected chronic kidney disease admitted with progressive severe disabling muscular pains predominantly over calves with constitutional symptoms for seven weeks.
He was weak to mobilize out of the bed.
Later, he developed a vasculitic rash, unilateral ulnar claw, and bilateral foot drop.
His skin and muscle biopsies showed evidence of vasculitis.
His renal and mesenteric artery CT angiogram revealed stenosed segment of the celiac artery without evidence of visible aneurysms elsewhere.
He completed six cycles of intravenous cyclophosphamide pulse therapy with high-dose oral prednisolone with good response.
With continuation of aggressive immunosuppression and rehabilitation for five months, the patient improved and was able to walk without support.
Conclusion.
Musculoskeletal predominant PAN, even though rare, needs to be considered in patients presenting with disabling muscle pain and weakness.
These features may herald over days to months along with constitutional symptoms before other systems getting affected.
Early recognition of such symptoms and initiating specific treatment would be important for better outcomes.
American Psychological Association (APA)
Senarathna, H. M.& Fonseka, C. L.& Perera, H. A. S.& De Silva, P. U. T.& Weerarathna, Thilak. 2019. Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa. Case Reports in Rheumatology،Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1144229
Modern Language Association (MLA)
Senarathna, H. M.…[et al.]. Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa. Case Reports in Rheumatology No. 2019 (2019), pp.1-5.
https://search.emarefa.net/detail/BIM-1144229
American Medical Association (AMA)
Senarathna, H. M.& Fonseka, C. L.& Perera, H. A. S.& De Silva, P. U. T.& Weerarathna, Thilak. Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa. Case Reports in Rheumatology. 2019. Vol. 2019, no. 2019, pp.1-5.
https://search.emarefa.net/detail/BIM-1144229
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144229