A case of adult polyarteritis nodosa associated with streptococcal infection

Abstract

    A 42-year-old female developed sore throat and high-grade fever in the beginning of May 2005. Antibiotic therapy was not effective for her symptoms, so she was transferred to our hospital. On admission day, we found erythema nodosum and marked by elevated CRP (21.0 mg/dl) and erythrocyte sedimentation rate (130 mm/hr), accompanying severe anemia (Hb 8.4 g/dl). All the immunological tests including antinuclear antibodies, rheumatoid factor, MPO-ANCA were negative while ASO was marked by elevates. The urinalysis was normal. By an abdominal angiography, we found both partial stenosis and dilation in upper mesenteric artery. A diagnosis of polyarteritis nodosa (PN) was made. After 40 mg daily prednisolone therapy, her symptoms and the abnormal laboratory data have recovered in a short period. We consider that this is a kind of rare case of adult PN, which developed in association with preceding acute streptococcal infection.