Paul J. Tejada-Llacsa , Julia Sumire Umes , Manuel Francisco Ugarte-Gil , Graciela S. Alarcón , Víctor Román Pimentel-Quiroz
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Chronic diarrhea as initial manifestation of polyarteritis nodosa: A case-based review
Introduction
Polyarteritis nodosa is a rare form of vasculitis which affects medium and small arteries. Gastrointestinal involvement occurs in 14–65% of patients, the most common symptom being abdominal pain; in a few cases, intestinal perforation may occur. Chronic diarrhea at disease onset is, however, very uncommon.
Objective
To present the case of an elderly man with chronic diarrhea as the main manifestation of polyarteritis nodosa that progressed to intestinal perforation.
Material and methods
The diagnosis of polyarteritis nodosa was made by intestinal biopsy; cyclophosphamide was administered as induction treatment with progressive clinical improvement. Furthermore, a PubMed literature review was conducted.
Results
Three communications on which diarrhea was reported as a manifestation of polyarteritis nodosa; in one of these patients, a 13-year-old girl, chronic diarrhea was the main manifestation.
Conclusion
This case illustrates the diagnostic complexity of polyarteritis nodosa due to non-specific symptoms and atypical presentation such as diarrhea, underscoring the importance for early recognition and intervention.
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