MyPACS.net: Radiology Teaching Files > Case 2941351

never visited BILATERAL INFILTRATES
Contributed by: Kristi Takaki, Resident, Virginia Mason Medical Center, Washington, USA.
Patient: 17 year old female
History: Indian female initially presented with malaise, fatigue, fever, and vague back pain.
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Findings: Diffuse bilateral airspace opacities.
Diagnosis: Labs were significant for anemia and creatinine of 2.3. Renal biopsy showed necrotizing and crescentic glomerulonephropathy with positive pANCA. Negative Hep B and C serologies.
Discussion:

Polyarteritis nodosa is an autoimmune disease that affects that small and medium sized vessels. Transmural necrotizing inflammation causes weakening of the arterial wall, aneurysmal dilatation, and localized rupture.

Skin, joints, peripheral nerves, gastrointestinal (GI) tract, and kidney involvement is common. Pulmonary hemorrhage is rare in PAN, but more frequent in hepatitis related PAN.

Ddx:
Goodpasture's disease (anti GBM)
Wegener's (almost exclusively c-ANCA)

References: emedicine
Comments:
No comments posted.
Additional Details:

Case Number: 2941351Last Updated: 10-15-2005
Anatomy: Lung   Pathology: Non-Infectious Inflammatory Disease
Exam Date: 00-00-0Access Level: Readable by all users

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