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At least 19 recordsLinked to original sources
PubMed1988

Periarteritis of coronary arteries with severe eosinophilic infiltration. A new pathologic entity (eosinophilic periarteritis)?

A 40 year-old male presented symptoms of angina pectoris for about nine years and expired with symptoms of unstable angina, changing pattern at the terminal stage. At autopsy, both right and left coronary arteries of the subepicardial region were grayish white and elastic hard. Histologically, inflammatory infiltration was localized in adventitia of coronary arteries located in the subepicardial region. Inflammatory cells infiltrated into the adventitia were mostly eosinophiles. The medial smooth muscle cells were well preserved and the intima showed irregular thickening with fibrosis. Vascular obstruction or recanalization could not be observed. As a result of these findings, it was considered that these inflammatory changes of the coronary arteries could be termed eosinophilic periarteritis. These inflammatory changes could not be found in the intramural coronary arteries. Rather extensive fibrosis could be seen in the muscle layer centering about the posterior wall of the left ventricle. No findings of angiitis could be detected in the blood vessels except subepicardial coronary arteries.

Adult↗
PubMed1997

[Clinical symptomatology and prognosis of periarteritis nodosa in the elderly. Retrospective study of 25 periarteritis nodosa cases in young adults and 22 cases in aged patients].

Between 1985 and 1995, 47 patients with evidence of polyarteritis nodosa were seen at the department of Internal Medicine. Thirty-nine patients fulfilled histological and/or arteriographic diagnostic criteria, and in eight patients, the diagnosis was based on clinical criteria. At the onset of the disease, 25 patients were below the age of 65 (group A) and 22 were above the age of 65 (group B). Except for increased frequency of weight loss in group B and increased frequency of cutaneous signs (purpura and nodes) in group A, no significant differences were found in clinical and biological features. The mean duration of follow-up was 46.9 +/- 36.5 months. The number of deaths was significantly higher among the elderly (ten deaths in group B versus two in group A).

Adult↗
PubMed1996

[Acute cholecystitis in periarteritis nodosa. 8 cases].

OBJECTIVES: Analyze clinical manifestations and laboratory findings in patients with periarteritis nodosa who developed acute cholecystitis in order to determine their value for prognosis and management. PATIENTS AND METHODS: We report 8 cases of acute cholecystitis which revealed or occurred as a complication of periarteritis nodosa. These were 4 men and 4 women, mean age 50 years. Periarteritis nodosa was diagnosed on the basis of histological evidence and/or clinical expression. Complimentary explorations included: sonography of the biliary tree, cholecystogram or cholangiogram in addition to diagnostic work-up for periarteritis nodosa. RESULTS: The clinical or sonographic presentation was similar to common cases of cholecystitis. However, no stone were observed in 2/8 cases. Histologically, the gall bladder showed characteristic vascular lesions suggestive of periarteritis nodosa in 7 out of 8 cases (no operation in 1 case). Cholecystitis was the inaugural sign in 2 cases. Surgery was performed for lithiasic forms. Medical management with methylprednisolone i.v. was used successfully in the alithiasic forms. In the 2 cases with inaugural solitary acute cholecystitis. lithiasis was found in the surgical specimen in 1 case; the pathology examination gave the etiological diagnosis. There was no lithiasis in one case with inaugural cholecystitis. CONCLUSIONS: The development of acute cholecystitis in patients with periarteritis nodosa is uncommon but should be treated surgically in case of lithiasis or when the cholecystitis is the inaugural sign. Unlike digestive tract involvement, periarteritis nodosa does not aggravate the clinical course. Alithiasic forms may be treated medically with corticosteroids. In our opinion, therapeutic abstention, sometimes proposed in patients with necrotizing angiitis of the gall bladder, is not always indicated as some patients can benefit from medical treatment of the underlying periarteritis nodosa.

Acute Disease↗
PubMed1980

Periarteritis nodosa in spontaneously hypertensive rats--immunohistological study and permeability test.

Spontaneously hypertensive rats develop periarteritis nodosa spontaneously with high incidence. Immunohistology of periarteritis nodosa reveals that fibrinogen constantly deposits in the wall of the diseased artery in exceptional combination with IgG but never with complement (C3). This fact suggests that periarteritis nodosa in spontaneously hypertensive rats may not be arteritis of immune complex type. Permeability test using mainly peroxidase as a tracer demonstrates that increased arterial permeability in spontaneously hypertensive rats is recognizable since 4 to 6 months of age without sexual difference in its intensity. In male spontaneously hypertensive rats periarteritis nodosa is observed in 6 of 11 and the arterial permeability increases more pronouncedly in the positive group, whereas 5 female spontaneously hypertensive rats of various ages are free from periarteritis nodosa irrespective of high arterial permeability. Therefore, high arterial permeability does not always lead to regular development of periarteritis nodosa especially in female spontaneously hypertensive rats.

Animals↗
PubMed1984

[Arterial hypertension in periarteritis nodosa. 37 case reports].

Hypertension in periarteritis nodosa poses the problem of aetiology, prognostic significance and treatment. Thirty seven cases of periarteritis noda with hypertension were analysed with à follow-up of over 10 years. These cases were taken from a series of 91 patients with polyarteritis nodosa admitted to the Department of Internal Medecine at the Pitié Hospital, between 1960 and 1980. Hypertension was observed on admission in 40% of the patients and developed during the first year of the disease in another 40%. The prognosis of patients with polyarteritis nodosa and hypertension is not significantly different from those without hypertension during the first six years. The overall prognosis depends mainly on the degree of renal involvement. The hypertension is renovascular in a number of cases due to ischaemia of the renal cortex. This was demonstrated by renal arteriography or by evaluating plasma renin activity in the renal veins. In some cases, especially those in which the hypertension preceded the periarteritis nodosa, the hypertension seemed to progress independently. In some cases, however, it was not possible to determine the relationship between the periarteritis nodosa and the hypertension or confirm that this association was coincidental. The use of angiotensin I converting enzyme inhibitors is an important advance in the treatment of the hypertension of periarteritis nodosa with high plasma renin activity as it counteracts the exact mechanism of the hypertension. Their use is justified in high plasma renin activity hypertension of periarteritis nodosa; patients who fail to respond may be treated with betablockers or other antihypertensive drugs.

Adolescent↗
PubMed1976

Kawasaki disease. Relationship with infantile periarteritis nodosa.

Until 1972, Kawasaki disease, or acute febrile infantile mucocutaneous lymph node syndrome (MCLS), was considered in Japan to be a nonfatal disease with a favorable prognosis. Based on the findings from two autopsy cases of MCLS, we believe that sudden and unexpected death during convalescence may be due to arterial lesions, especially those involving the coronary artery, that resemble those of periarteritis nodosa. Of 29 autopsy cases of MCLS, gathered from all over Japan, all exhibited arteritis lesions (eg, aneurysm due to coronary arteritis). Such vascular pathological findings may in fact represent the same entity as infantile periarteritis nodosa. Whether infantile periarteritis nodosa can be identified with the adult type is still debatable. The particular manifestations of infantile periarteritis nodosa might be related to severe vasculitis. Autopsy cases of infantile periarteritis nodosa without MCLS manifestations are being collected and studied.

Age Factors↗
PubMed1988

[Periarteritis nodosa related to hepatitis B virus. Determination of a new therapeutic strategy: 13 cases].

The treatment and prognosis of periarteritis nodosa associated with hepatitis B virus were reconsidered from a series of 13 patients representing 32.5 per cent of the 40 patients with periarteritis nodosa admitted during the same period. HBs and HBe antigens were present in every case, and hepatitis B virus replication was demonstrated by the finding of viral DNA in serum. One patient had anti-HBc IgM's. Five patients were treated with corticosteroids, cyclophosphamide and occasional plasma exchanges. All were cured or achieved complete remission. Eight patients were treated with plasma exchanges and vidarabine, either as first-line therapy (3 cases) or after failure of corticosteroids and/or immunosuppressants (5 cases). This treatment was clinically effective in 5/8 cases, including 3 with seroconversion. The 2 patients in whom the combined treatment failed were given corticosteroids; one of them also had plasma exchanges. The 8th patient died after a few days of treatment. Eleven of the 13 patients are still alive and either cured or in complete remission. Two patients who developed severe chronic hepatitis after steroids were discontinued received vidarabine alone: arrest of viral replication was obtained in both cases, with emergence of an anti-HBe (but not anti-HBs) antibody. The overall positive virological response rate to vidarabine alone or combined with plasma exchanges was 50 per cent. When vidarabine was prescribed as treatment of acute periarteritis nodosa (the 2 cases where it was used for chronic hepatitis being excluded), this response rate was 37.5 per cent. This, in patients with periarteritis nodosa associated with hepatitis B virus immunosuppressive drugs should be withdrawn and replaced by plasma exchanges and antiviral agents. This would be the first-line treatment to be replaced by corticosteroid therapy if it fails.

Combined Modality Therapy↗
PubMed1998

Theophylline-induced mesenteric periarteritis in F344/N rats.

The toxicity and carcinogenic potential of theophylline (an alkaloid bronchodilator drug) was investigated in male and female F344/N rats in 16-day, 14-week, and 2-year gavage and feeding studies. In 16-day studies, rats were fed diets containing 0, 500, 1000, 2000, 4000, and 8000 ppm of theophylline or given 0, 12.5 (twice daily), 25 (once daily), 50 (once daily), 50 (twice daily), 100 (once daily), 200 (once daily), 200 (twice daily), and 400 (once daily) mg theophylline/kg body weight in corn oil by gavage. In 14-week studies, rats were fed diets containing 0, 1000, 2000, and 4000 ppm theophylline or given 0, 37.5, 75, and 150 mg/kg body weight theophylline in corn oil by gavage. In 2-year gavage studies, rats were given 0, 7.5, 25, and 75 mg/kg body weight in corn oil. In 16-day gavage studies, treatment-related periarteritis occurred in arteries of the pancreas and adjacent to the mesenteric lymph nodes of early death male and female rats given 400 mg/kg once daily. In the 14-week studies, treatment-related periarteritis occurred at similar sites and in male rats exposed to 75 and 150 mg/kg, and in all exposed female rats (gavage studies), in females exposed to 1000 ppm, and in both sexes exposed to 2000 and 4000 ppm (feeding studies). In the 2-year study, chronic periarteritis was significantly increased only in the males receiving 75 mg/kg of theophylline. The adventitia, media and intima of medium- and large-sized mesenteric arteries were involved. Similar to other vasodilator chemicals, the pathogenesis of theophylline-induced vascular lesions may be a consequence of hemodynamic changes induced in the vascular wall.

Administration, Oral↗
PubMed2005

[Reversible lower limb lymphedema as the first manifestation of cutaneous periarteritis nodosa].

INTRODUCTION: Cutaneous periarteritis nodosa is a localized form middle-sized arteriolitis. Its main clinical features are nodules, livedo reticularis and ulcers of the lower limbs. EXEGESIS: We reported a 45 year-old woman with distal lower limb lymphedema. Lymphedema initially spontaneously remitted but recurred nine months after, accompanied with nodules. Cutaneous periarteritis nodosa was diagnosed on histological findings and absence of extracutaneous manifestations. Lymphoscintigraphy showed functional lymphatic insufficiency. Treatment consisted of prednisone followed by colchicine and dapsone. After six months of follow-up, patient remained symptom-free. CONCLUSION: We report the first case of lower limb lymphedema associated with cutaneous periarteritis nodosa. Parallel course and unusual corticosensivity of lymphedema and nodules raised the problem of their non coincidental association.

Anti-Inflammatory Agents↗
PubMed2005

[Cerebral angiitis caused by periarteritis nodosa].

INTRODUCTION: We report a case of periarteritis nodosa revealed by a cerebral angiitis which recovered under treatment. OBSERVATION: A 52-year-old patient suddenly presented with a left sensory syndrome and a fluctuating aphasia due to ischemia involving both parietal lobes. The diagnosis of periarteritis nodosa was based on the following criteria: severe loss of weight, renal insufficiency, hypertension, angiography suggesting an arteritis. Instead of an ileo-cecal perforation, the patient recovered under corticosteroid and immunosuppressive therapy. CONCLUSIONS: Stroke in periarteritis nodosa may occur early be and associated with a good outcome.

Aphasia↗
PubMed2001

[Adult cutaneous periarteritis nodosa and dental infections. Role of streptococci].

INTRODUCTION: Periarteritis nodosa can be associated with streptococcal infections in children. We report two cases of adult cutaneous periarteritis nodosa that disappeared after the treatment of dental infection. EXEGESIS: A 23-year-old woman presented with necrotic ulceration on the legs for 6 months, with a histology of necrotizing vasculitis. Many sites of dental infections could be noted. Immunological data were negative and so were serologies of hepatitis. Corticosteroid therapy failed. The teeth removal with antibiotic therapy allowed the disappearance of cutaneous lesions in a month. A 26-year-old woman was hospitalized for growing thin, fever, diffuse arthralgia and myalgia and cutaneous nodules on the legs with necrotizing vasculitis on dermal vessels at histological analysis. The biology showed no pecularity. Radiography of the teeth showed many dental infection sites. The removal of six teeth with antibiotic therapy led to the disappearance of vasculitis in 6 weeks. CONCLUSION: The search for an infectious problem is important when vasculitis is diagnosed, in particular periarteritis nodosa. The treatment of dental infection could occasionally mean avoiding immunosuppressive therapy in certain cases.

Adrenal Cortex Hormones↗
PubMed1999

The incidence and development of periarteritis nodosa in testicular arterioles and mesenteric arteries of spontaneously hypertensive rats.

We sought to clarify the incidence, vessel-size and age distribution of periarteritis nodosa in rats occurring as a vascular lesion in malignant hypertension. Stroke-prone spontaneously hypertensive and stroke-resistant spontaneously hypertensive rat strains were studied, as well as Wistar-Kyoto control rats. Mesenteric arteries and testicular arteries were examined histologically. Additionally, electron microscopy investigation was carried out on one stroke-prone hypertensive rat and one control. Periarteritis nodosa lesions were present in testicular arterioles in 57.1%, and mesenteric arteries in 28.6%, of stroke-prone hypertensive rats aged 9.5 mo. Lesion incidence at these sites was 100% and 60% respectively in 10 stroke-prone rats aged 15.5 mo, and 42.9% and 28.6% in stroke-resistant hypertensive rats aged 22.5 mo. In contrast, the incidence rate was 0% at both sites in stroke-resistant hypertensive rats aged 8 or 14.5 mo, and in control rats aged 9.5 or 25 mo. In stroke-prone rats, arteritis lesion counts (mean+/-SD) in testicular sections were 11.6+/-17 at age 9.5 mo and 96.3+/-60.9 at age 15.5 mo. In individual lesion scoring, arteritis was more severe in mesenteric arteries than in testicular arterioles. For arteriolar lesion distribution patterns in testicular sections, partial peripheral, partial peripheral plus central, and circumferential patterns were all noted. In conclusion, periarteritis nodosa in hypertensive stroke-prone rats occurs earlier in testicular arterioles, but attains greater severity in the mesenteric artery.

Animals↗
PubMedDate not supplied

Combined interferon, famciclovir and GM-CSF treatment of HBV infection in an individual with periarteritis nodosa.

Treatment of chronic hepatitis B virus (HBV) infection in an individual with periarteritis nodosum is described. A combination of famciclovir, granulocyte macrophage colony stimulating factor (GM-CSF) and interferon alpha 2b was utilized. The periarteritis, but not the HBV infection, responded to immunosuppressive therapy consisting of cyclophosphamide and glucocorticoids. Moreover, the patient failed to clear this HBV infection, despite a full year of interferon therapy at 5 MU daily. With the addition of famciclovir and GM-CSF, the HBV infection rapidly resolved and he converted from HBsAg and eAg positive to HBsAb and eAb positive. No exacerbation of his periarteritis nodosum occurred during the course of his antiviral therapy.

2-Aminopurine↗
PubMed1991

[Clinical significance of the determination of total serum IgE in periarteritis nodosa in children].

The content of IgE was measured over time in 14 children with periarteritis nodosa. No significant relation was established between allergic reactions in the anamnesis and IgE elevation in periarteritis nodosa. A relationship was discovered between the rise of IgE content and disease activity, the intensity of the clinical manifestations, vascular ones in particular. During a remission of periarteritis nodosa, the content of IgE remained within normal in all the children.

Adolescent↗