Polyarteritis nodosa with mesenteric aneurysms demonstrated by angiography: report of a case and successful treatment of the patient with prednisolone and cyclophosphamide

Polyarteritis nodosa is a necrotizing angitis that predominantly affects sm all and medium-sized arteries. The prognosis of untreated polyarteritis nod osa is very poor. Since symptoms are diverse and no serologic test is speci fic for polyarteritis nodosa, the diagnosis is difficult and often delayed. We describe a patient with polyarteritis nodosa who had gastrointestinal i nvolvement with multiple aneurysms of the inferior mesenteric artery; only abdominal angiography provided a conclusive diagnosis. Alleviation of sympt oms and regression of aneurysms were observed after combination therapy of an immunosuppressive agent, cyclophosphamide, and prednisolone. We emphasiz e the importance of early diagnosis by angiography and aggressive therapy i n patients in whom physical signs indicating definite polyarteritis nodosa are not present.