Benign cutaneous polyarteritis nodosa in children below 10 years of age--a clinical experience.

Abstract

Objective-To report 10 children younger than 10 years of age with benign cutaneous polyarteritis nodosa (BCPAN). Methods-Ten children aged 1 25-10 years (mean 4-7 years; M:F = 7:3) were admitted with an unusual vasculitis. The clinical features, laboratory investigations, treatment and follow up data were analysed.

Background noise of infection for using ANCA as a diagnostic tool for vasculitis in tropical and developing countries

“…Malaria produces an atypical ANCA pattern and vasculitis is uncommon with this disease. Clinical presentation of malaria is very well known in endemic areas and the high amount of immune complex generated in this infection could conceivably produce cryo globulinaemic vasculitis and together with ANCA positivity may mislead the clinician (Gopinathan and Bhalla 1987;Kumar et al 1995). This is particularly so if only the immunofluorescence test is available for ANCA detection as this test has a large subjective component and atypical ANCA (X-ANCA) may be reported as just ANCA positive.…”

“…Malaria is usually not associated with a vasculitic illness but cryoglobulinaemia is known to be associated with malaria and can cause vasculitis (Gopinathan and Bhalla 1987;Kumar et al 1995). As these infections far outnumber the idiopathic vasculitides described above there is every possibility of misinterpreting an ANCA positivity with TB, leprosy or malaria associated erythema nodosum as paucicellular vasculitis like Wegener's granulomatosis if the classical clinical features of the infections are not present and vice versa, even in a developed country where these infections are not common but may be imported or could even be rarely indigenous.…”

Stellate Red-Brown Patches on the Distal Extremities

“…2,4 Less common presentations include inflammatory plaques with peripheral nodules on the trunk and the extremities, 5 maculopapular eruption, vesiculobullous lesions, and pupura. 6 Because there is no specific serologic test for c-PAN, the diagnosis relies on clinicopathologic correlation. Biopsy reveals a necrotizing vasculitis involving medium-sized arteries in the deep dermis or subcutaneous tissue.…”

Polyarteritis nodosa and microscopic polyangiitis – The Indian experience

“…21,26 Cutaneous PAN has also been reported in children. 28 This was characterised by onset in the first decade of life and higher incidence of peripheral gangrene. In these 10 cases seen at PGI, Chandigarh, the authors reported possible association with diphtheria-pertussis tetanus immunisation (one), drugs (two), streptococcal infection (two), wasp sting (one) and falciparum malaria (one).…”