腸間膜動脈に限局した結節性多発動脈炎と考えられる1症例

Abstract

A 42-year-old man was admitted with massive gastrointestinal bleeding. The angiographic finding of superior and inferior mesenteric artery showed vascular stenoses, dilatation and multiple microaneurysms. Because of these characteristic findings, his disease was highly suspected to be polyarteritis nodosa (PN). After the differential diagnosis, immunosuppressive pulse therapy with corticosteroids or cyclophosphamide was carried out. By this succesful treatment, the vascular stenoses, dilatation and multiple microaneurysms of his superior and inferior mesenteric artery were remarkably improved. This case suggests that angiography of the abdominal artery is useful for the diagnosis of PN with intestinal symptoms and that intensive immunosuppressive therapy with corticosteroids and cyclophosphamide should be carried out.