Polyarteritis Nodosa with Cytomegalovirus Enteritis and Jejunoileal Perforation: Report of a Case with a Literature Review
Issued Date
2022-01-01
Resource Type
ISSN
11766344
eISSN
11782048
Scopus ID
2-s2.0-85135048512
Pubmed ID
35924006
Journal Title
Vascular Health and Risk Management
Volume
18
Start Page
595
End Page
601
Rights Holder(s)
SCOPUS
Bibliographic Citation
Vascular Health and Risk Management Vol.18 (2022) , 595-601
Suggested Citation
Waisayarat J. Polyarteritis Nodosa with Cytomegalovirus Enteritis and Jejunoileal Perforation: Report of a Case with a Literature Review. Vascular Health and Risk Management Vol.18 (2022) , 595-601. 601. doi:10.2147/VHRM.S354548 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86320
Title
Polyarteritis Nodosa with Cytomegalovirus Enteritis and Jejunoileal Perforation: Report of a Case with a Literature Review
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis affecting small-to medium-sized arteries. The most common gastrointestinal manifestation of PAN is postprandial abdominal pain from mesenteric arteritis causing bowel ischemia. When transmural ischemia develops, there may be ischemic necrosis and perforation of the bowel wall, which are life-threatening. Severe, life-threatening gastrointestinal involvement is relatively rare in pediatric PAN and may require different management in adult patients. We report a pediatric PAN case in a patient who presented with acute abdominal pain and superimposed cytomegalovirus enteritis with jejunoileal perforation. The patient improved with emergency small intestinal resection followed by conventional immunosuppressive drugs of a corticosteroid and cyclophosphamide, and anti-viral drugs. Before increasing the immunosuppressive drug dosage, initial screening of infectious cytomegalovirus and comprehensive evaluation for surgical conditions are essential in pediatric PAN with severe gastrointestinal involvement. Early aggressive treatment for acute abdomen is useful in reducing morbidity and mortality in pediatric PAN.