Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report)

Gabsi, Mayssem; Chenik, Sarra; Mahfoudhi, H.; Taamallah, Karima; Hajlaoui, Nadhem; Fehri, Wafa

doi:10.11604/pamj.2021.38.113.27601

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…However, a recent case report of AMI in a young patient with PAN demonstrated the use of PCI following a high dose of steroid management. It concluded careful monitoring of coronary arteries during the chronic phase of PAN [21]. The study also reported sudden cardiac death of the patent, likely due to stent thrombosis [21].…”

Section: Discussionmentioning

confidence: 81%

“…It concluded careful monitoring of coronary arteries during the chronic phase of PAN [21]. The study also reported sudden cardiac death of the patent, likely due to stent thrombosis [21]. Given the limited literature, we are unable to determine long-term survival rates after PCI in AMI with vasculitis and this requires more longitudinal studies.…”

Section: Discussionmentioning

confidence: 98%

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Predictors of Acute Myocardial Infraction in Patients With Vasculitis: A Nationwide Inpatient Cross-Sectional Study

Kaur¹,

Bajwa²,

Loh³

et al. 2022

Cureus

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The primary goal of this study is to explore demographic and comorbid factors that increase the hospitalization risk of acute myocardial infarction (AMI) in patients with vasculitis along with the utilization rate of percutaneous coronary intervention (PCI)/angioplasty. Additionally, we aim to study the prevalence of AMI in vasculitis inpatients based on geographical distribution. MethodsWe conducted a retrospective cohort study using the Nationwide Inpatient Sample (NIS) in 2019 involving 33,210 inpatients hospitalized on emergency-based admissions with a co-diagnosis of vasculitis, subdivided into cohorts without AMI (N = 31,790) and with AMI (N = 1,420) as the primary diagnosis. A binomial logistic regression model was used to evaluate the odds ratio (OR) of predictors associated with AMI in patients with vasculitis compared to the non-AMI cohort. ResultsThe prevalence of AMI in the total inpatient population with vasculitis was 4.28%, with a majority of patients being in the older age group of 51-65 years (63%), males (59.2%), and white (59%). Inpatients with vasculitis having pre-existing co-morbid conditions were at greater risk for AMI, such as obesity (OR 2.84, 95%CI 2.78-2.89), metastatic cancer (OR 1.73, 95%CI 1.26-2.37), complicated hypertension (OR 1.64, 95%CI 1.46-1.85), and arthropathies (OR 1.48, 95%CI 1.30-1.68). The in-hospital mortality rate was significantly higher in the AMI cohort compared to the non-AMI cohort (13% vs 2.9%). The utilization rate of PCI/endovascular angioplasty was 13.02% (185 out of 1,420) and had a lower in-hospital mortality rate compared to those managed by medical treatment (8.1% vs 13.8%). ConclusionAMI is an important differential diagnosis to consider in vasculitis patients admitted into the hospital with chest pain. Due to the low prevalence of vasculitis and diagnostic challenges, these primary conditions can be often missed. There is a greater risk of inpatient mortality among vasculitis patients with AMI. Therefore, a higher index of suspicion should be exercised, especially in elderly males with risk factors. Vasculitis patients with chronic comorbidities such as arthropathies, obesity and hypertension are at a greater risk for suffering from AMI. Careful screening and management of cardiovascular risk factors is mandatory in vasculitis patients.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 98%

Predictors of Acute Myocardial Infraction in Patients With Vasculitis: A Nationwide Inpatient Cross-Sectional Study

Kaur¹,

Bajwa²,

Loh³

et al. 2022

Cureus

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“…Una manera que se ha evidenciado para diferenciarla de otras vasculitis es mediante el resultado de ANCA séricos negativos. (Chercoles y Fong, 2016;Helfgott y Bhattacharyya, 2022;Zahoor et al, 2022;Gaviria et al, 2020, Naidu et al, 2021 -Imágenes: Angiorresonancia, Angiotomografía y/o Angiografía en las que se pueden observar dilataciones o estrechamientos de las arterias afectadas (Munera-Campos et al, 2020;Gabsi et al, 2021) como lo es la presencia de micro aneurismas, los cuales son distintivos de la PAN. (Wuelan, 2022) -Biopsia: se observa vasculitis leucocitoclástica de arterias de mediano calibre, necrosis de las paredes del vaso, asociado a marcada inflamación perilesional (Jennette, 2013;Sociedad Argentina de Reumatología, 2022), la biopsia debe centrarse sobre un nódulo sensible o una lesión purpúrica (Michelitti, 2022).…”

Section: Introductionunclassified

Poliarteritis nodosa. A propósito de un caso

Moreno,

Bustamante,

Neira

2023

GICOS

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La poliarteritis nodosa es una vasculitis necrotizante de rara presentación que afecta vasos de mediano y pequeño calibre, que puede afectar desde un órgano hasta sistemas del cuerpo humano, por lo tanto, su presentación clínica es variable y su etiología es predominantemente idiopática. Respecto a su diagnóstico, se deben descartar otras patologías y correlacionar la clínica, las imágenes diagnósticas y paraclínicos disponibles, con el fin de brindar una terapia adecuada y oportuna, teniendo en cuenta que la terapia farmacológica ayuda a disminuir el daño y la progresión más no es una cura. Se presenta el caso de un paciente de 46 años con poliarteritis nodosa cutánea rápidamente progresiva que llevó a necrosis de los dedos de las 4 extremidades, se logró estabilizar y detener su progresión mediante el reconocimiento y manejo farmacológico con glucocorticoides y citotóxicos, sin embargo, requirió amputación.

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Polyarteritis nodosa complicated by renal aneurysm and intestinal perforation: A case report

Ma,

Luan,

Zhang

et al. 2024

Medicine

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Rationale: Polyarteritis nodosa (PAN) is a necrotizing vasculitis that affects small- and medium-sized arteries, presenting with diverse clinical manifestations. It can impact tissues and organs throughout the body and may be life-threatening in severe cases. Common causes of death include cardiac, renal, and gastrointestinal complications or aneurysm rupture. While separate reports of renal aneurysm and intestinal perforation exist, the coexistence of these conditions is rarely documented. This study reports a severe case of PAN complicated by both renal aneurysm and intestinal perforation, aiming to deepen the understanding of this disease, aid in clinical diagnosis and treatment, and improve patient prognosis. Patient concerns: The patient presented to the hospital with dorsal foot pain and abdominal pain persisting for more than 4 months, along with pain and discomfort in both lower extremities for over 1 month. Interventions: The patient was diagnosed with PAN, renal aneurysm, intestinal perforation, and grade 3 hypertension (high risk). Outcomes: After treatment, the patient showed normal temperature and blood pressure, relief from abdominal pain, and disappearance of myalgia and numbness in the lower limbs. Additionally, the renal aneurysm shrank significantly, the intestinal perforation healed, the ileostomy was reduced, and the patient’s condition stabilized. Lessons: The clinical symptoms of PAN mostly lack specificity, and should be distinguished from microscopic polyangiitis and simulated vasculitis. For patients with intestinal perforation similar to this case, tocilizumab treatment may be effective, but further research is needed to confirm it.

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Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report)

Cited by 3 publications

References 8 publications

Predictors of Acute Myocardial Infraction in Patients With Vasculitis: A Nationwide Inpatient Cross-Sectional Study

Predictors of Acute Myocardial Infraction in Patients With Vasculitis: A Nationwide Inpatient Cross-Sectional Study

Poliarteritis nodosa. A propósito de un caso

Polyarteritis nodosa complicated by renal aneurysm and intestinal perforation: A case report

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