2024/12/31 by Yahyaoui, S., Mazigh S, Benrabeh R +3
#ANCA #Childhood #Polyarteritisnodosa #Vasculitis
paper · doi:10.71566/pist-rmp-194808
We report the case of a five years old boy presented with abundant hematemesis. Following resuscitation, upper gastrointestinal endoscopy was performed and showed a duodenal ulcer. Under medical treatment, the haematemesis recurred with hemorrhagic shock, requiring a laparotomy. Preoperatively, a bleeding ruptured aneurysm of the right renal artery was discovered. The postoperative course was marked by the occurrence of High blood pressure and peripheral neuropathy. Arteriography confirmed aneurismal dilatation of the right renal artery. Erythrocyte sedimentation rate was of 110mm/hour. Antineutrophil cytoplasmic antibodies, serum cryoglobulins and anti-DNA antibodies were negative. Comple- ment levels were within normal ranges. The diagnosis of PAN was made. The patient was managed by predni- sone and cyclophosphamide with good outcome. In the cases of seemingly obscure gastrointestinal bleeding or the occurrence of duodenal ulcer in children without risk factors for peptic ulcer, the diagnosis of necrotizing vasculitis should be suspected. At least, Ery- throcyte sedimentation rate should be early performed in these patients