Poliarteritis nodosa. A propósito de un caso
Polyarteritis nodosa. About a case
Resumen
La poliarteritis nodosa es una vasculitis necrotizante de rara presentación que afecta vasos de mediano y pequeño calibre, que puede afectar desde un órgano hasta sistemas del cuerpo humano, por lo tanto, su presentación clínica es variable y su etiología es predominantemente idiopática. Respecto a su diagnóstico, se deben descartar otras patologías y correlacionar la clínica, las imágenes diagnósticas y paraclínicos disponibles, con el fin de brindar una terapia adecuada y oportuna, teniendo en cuenta que la terapia farmacológica ayuda a disminuir el daño y la progresión más no es una cura. Se presenta el caso de un paciente de 46 años con poliarteritis nodosa cutánea rápidamente progresiva que llevó a necrosis de los dedos de las 4 extremidades, se logró estabilizar y detener su progresión mediante el reconocimiento y manejo farmacológico con glucocorticoides y citotóxicos, sin embargo, requirió amputación.
ABSTRACT
Polyarteritis nodosa is a rare necrotizing vasculitis that affects medium and small caliber vessels, which can affect from one organ to systems of the human body, therefore, its clinical presentation is variable and its etiology is predominantly idiopathic; Regarding its diagnosis, other pathologies must be ruled out and the clinic, diagnostic and paraclinical images available must be correlated, in order to provide adequate and timely therapy, taking into account that pharmacological therapy helps to reduce damage and further progression but is not a cure. The case of a 46-year-old patient with rapidly progressive cutaneous polyarteritis nodosa that led to necrosis of the fingers of the 4 extremities is presented. It was possible to stabilize and stop its progression through recognition and pharmacological management with glucocorticoids and cytotoxic drugs, however, it required amputation.
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Referencias
Barón-Barón, J., Pérez-Chona, C. y Vargas-Rodríguez, L. (2020). Poliarteritis nodosa. Acta Médica Colombiana, 45(2). https://doi.org/10.36104/amc.2020.1388
Bayazeed, L., Felimban, A., Alsaiad, A., Alsufiani, F. & Alqanatish, J. (2022). Myocardial Infarction in a 7-Year-Old Girl with Polyarteritis Nodosa. Hindawi. https://doi.org/10.1155/2022/2175676
Bettuzzi, T., Jachiet, M., Sbidian, E., Frumholtz, L., Cordoliani, F., Mouthon, L., Chasset, F., Paule, R., Bouaziz, J. D., Guillevin, L., Terrier, B., Aractingi, S., Dupin, N. & Régent, A. (2022). Efficacy and safety of treatments in cutaneous polyarteritis nodosa: A French observational retrospective study. Journal of the American Academy of Dermatology, 86(5), 1035–1041. https://doi.org/10.1016/j.jaad.2021.06.872
Boistault, M., Lopez, M., Quartier, P., Berbel, L., Carsi, A. & Aeschlimann, F. (2021). A young girl with severe polyarteritis nodosa successfully treated with tocilizumab: a case report, Pediatric Rheumatology Online Journal, 19, 168.
Cárdenas, L., Parsons, A., Sangüeza, O. y Tobón, M. (2010). Poliarteritis nodosa cutánea. Revista Asociación Colombiana de Dermatología, 18, 40-42.
Chércoles, L., y Fong, J. (2016). Algunas especificidades sobre las vasculitis. MEDISAN, 20(11). http://www.medisan.sld.cu/index.php/san/article/view/908
Chung, S., Gorelik, M., Langford, C., Maz, M., Abril, A., Guyatt, G., Archer, A., Conn, D., Full, K., Grayson, P., Ibarra, M., Imundo, L., Kim, S., Merkel, P., Rhee, R., Seo, P., Stone, J., Sule, S., Sundel, R., Vitobaldi, O.,… Mustafa, R. (2021). 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Polyarteritis Nodosa. Arthritis & Rheumatology, 73(8), 1384–1393. https://doi.org/10.1002/art.41776
Collins, M. & Hadden, R. (2017). The nonsystemic vasculitic neuropathies. Nature reviews. Neurology, 13(5), 302–316. https://doi.org/10.1038/nrneurol.2017.42
Criado, P., Marques, G., Morita, T. & de Carvalho, J. (2016). Epidemiological, clinical and laboratory profiles of cutaneous polyarteritis nodosa patients: Report of 22 cases and literature review. Autoimmunity reviews, 15(6), 558–563. https://doi.org/10.1016/j.autrev.2016.02.010
De Virgilio, A., Greco, A., Magliulo, G., Gallo, A., Ruoppolo, G., Conte, M., Martellucci, S. & de Vincentiis, M. (2016). Polyarteritis nodosa: A contemporary overview. Autoimmunity reviews, 15(6), 564–570. https://doi.org/10.1016/j.autrev.2016.02.015
Fett, N. (2022). Evaluation of adults with cutaneous lesions of vasculitis. https://www.uptodate.com/contents/evaluation-of-adults-with-cutaneous-lesions-of-vasculitis
Gabsi, M., Chenik, S., Mahfoudhi, H., Taamallah, K., Hajlaoui, N. & Fehri, W. (2021). Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report). The Pan African medical journal, 38, 113. https://doi.org/10.11604/pamj.2021.38.113.27601
Gaviria, A., Patino, W., Ruiz, M., Mejia, A., Ruiz, A., & Marquez, P. (2020). Fluctuating facial edema as a rare manifestation of cutaneous polyarteritis nodosa: Case report and review of the literature. Journal of cutaneous pathology, 47(11), 1076–1079. https://doi.org/10.1111/cup.13833
Halabi, C., Williams, E., Morshed, R., Caffarelli, M., Anastasiou, C., Tihan, T., Cooke, D., Abla, A., Dowd, C., Shah, V., Chung, S. & Richie, M. (2021). Neurological manifestations of polyarteritis nodosa: a tour of the neuroaxis by case series. BMC neurology, 21(1), 205. https://doi.org/10.1186/s12883-021-02228-2
Helfgott, S. & Bhattacharyya, S. (2022) Clinical manifestations and diagnosis of vasculitic neuropathies, UpToDate. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-vasculitic-neuropathies
Hernández-Cardona, MÁ., Ramos-Garibay, JA y Valdés-Morales, KL. (2021). Poliarteritis nodosa cutánea: presentación de dos casos y revisión de literatura. Revista del Centro Dermatológico Pascua, 30(2), 84-88. doi:10.35366/101178.
Iglesias, A., Ariza A., Donado de Ariza, M., Chinchilla, A., Egea, E. y Blanco, A. (1986). Panarteritis nodosa variante ulcero-necrótica. Acta Médica Colombiana, 291-296.
Jennette J. (2013). Overview of the 2012 revised International Chapel Hill Consensus Conference nomenclature of vasculitides. Clinical and experimental nephrology, 17(5), 603–606. https://doi.org/10.1007/s10157-013-0869-6
Kapur, S. y Oswal, J. (2021). Acute pancreatitis as a presenting feature in a child with systemic polyarteritis nodosa. Indian journal of pathology y microbiology, 64(Supplement), S180–S181. https://doi.org/10.4103/IJPM.IJPM_804_20.
Karadag, O., Erden, A., Bilginer, Y., Gopaluni, S., Sari, A., Armagan, B., Ertenli, I., Ozen, S. & Jayne, D. (2018). A retrospective study comparing the phenotype and outcomes of patients with polyarteritis nodosa between UK and Turkish cohorts. Rheumatology International, 38(10), 1833–1840. https://doi.org/10.1007/s00296-018-4122-1
Kato, A., Hamada, T., Miyake, T., Morizane, S., Hirai, Y., Yamasaki, O y Iwatsuki, K. (2018). Marcadores clínicos y de laboratorio asociados a la recidiva en la poliarteritis nodosa cutánea. Dermatología JAMA, 154(8), 922–926. https://doi.org/10.1001/jamadermatol.2018.1601
Kermani, T., Warrington, K. y Dua, A. (2022). Treatment Guidelines in Vasculitis. Rheumatic diseases clinics of North America, 48(3), 705–724. https://doi.org/10.1016/j.rdc.2022.03.006
Li, L. y Lao, Y. (2021). Bacterial-Infection-Associated Polyarteritis Nodosa Presenting as Acute, Rapidly Progressive Multiple Hepatic Artery Aneurysms. Vascular and endovascular surgery, 55(3), 295–299. https://doi.org/10.1177/1538574420968682
Lightfoot, R., Michel, B., Bloch, D., Hunder, G., Zvaifler, N., McShane, D., Arend, W., Calabrese, L., Leavitt, R. y Lie, J. (1990). The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis and rheumatism, 33(8), 1088–1093. https://doi.org/10.1002/art.1780330805.
Matsuo, S., Hayashi, K., Morimoto, E., Kato, A., Sada, K., Watanabe, H., Takano-Narazaki, M., Sunahori-Watanabe, K., Kawabata, T. y Wada, J. (2017). The Successful Treatment of Refractory Polyarteritis Nodosa Using Infliximab. Internal Medicine, 56(11), 1435–1438. https://doi.org/10.2169/internalmedicine.56.8235
Medina A., Calle M., Eraso-Garnica, R., Peinado-Acevedo J., Vanegas-García A., Jaramillo-Arroyave, D., Muñoz-Vahos, C., Hernández-Zapata, L. (2022). Perfil demográfico y clínico de la poliarteritis nodosa sistémica y cutánea en un grupo de pacientes pediátricos de Medellín, 2010-2019. Revista Médica de IATREIA, 35(2). DOI 10.17533/udea.iatreia.122
Merkel, P. (2022). Clinical manifestations and diagnosis of polyarteritis nodosa in adults. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-polyarteritis-nodosa-in-adults
Merkel, P. (2022). Overview of and approach to the vasculitides in adults. https://www.uptodate.com/contents/overview-of-the-management-of-vasculitis-in-adults
Merkel, P. (2022). Treatment and prognosis of polyarteritis nodosa. https://www.uptodate.com/contents/treatment-and-prognosis-of-polyarteritis-nodosa
Micheletti, R. (2022). Cutaneous polyarteritis nodosa. https://www.uptodate.com/contents/cutaneous-polyarteritis-nodosa
Morel, Z., Melgarejo, P., Franco, M. y Delgadillo, P. (2018) Poliarteritis nodosa sistémica y cutánea en niños. Revista Paraguaya de reumatología, 4(2), 52-57. DOI: 10.18004/rpr/2018.04.02.52-57
Munera-Campos, M., Bielsa, I., Martínez-Morillo, M., Aparicio, G., Olivé, A. & Ferrándiz, C. (2020). Manifestations, clinical course and prognostic markers in cutaneous polyarteritis nodosa. Journal der Deutschen Dermatologischen Gesellschaft. Journal of the German Society of Dermatology, 18(11), 1250–1259. https://doi.org/10.1111/ddg.14271
Naidu, G., Kopp, C. R., Sharma, V., Singhal, M., Pinto, B., Dhir, V., Nada, R., Minz, R. W., Jain, S. & Sharma, A. (2021). Validation of the provisional seven-item criteria for the diagnosis of polyarteritis nodosa. Rheumatology international, 41(9), 1651–1655. https://doi.org/10.1007/s00296-021-04867-7
Ochoa, C., Ramírez, F., Quintana, G., Toro, C., Cañas, C., Osio, L., Cantillo, J., Rondón, F., Díaz, M., Coral, P., Chalem, P., Vásquez, G., Uribe, O., Ramírez, L., Quintana, M., Arana, B., Domínguez, A., Valle, R., Candia, L., Méndez, O., Chalem, M., Restrepo, J., Iglesias-Gamarra, A. (2009). Epidemiología de las vasculitis primarias en Colombia y su relación con lo informado para Latinoamérica. Revista Colombiana de Reumatología, 16(3), 248-263. http://www.scielo.org.co/scielo.php?script=sci_arttextypid=S0121-81232009000300002ylng=enytlng=es
Ordóñez-Parra, J., Castellanos-Angarita, A., Casas-Barrera, M., Rondón-Carvajal, J. y Cuéllar-Ríos, I. (2021). Poliarteritis nudosa cutánea: un simulador atípico. Informe de 3 casos y revisión narrativa de la literatura. Revista Colombiana de Reumatología. DOI: 10.1016/j.rcreu.2020.12.004
Papachristodoulou, E., Kakoullis, L., Tiniakou, E. & Parperis, K. (2021). Therapeutic options for cutaneous polyarteritis nodosa: a systematic review. Rheumatology, 60(9), 4039–4047. https://doi.org/10.1093/rheumatology/keab402
Parperis, K. y Rast, F. (2017). Inner Peace: Cutaneous Polyarteritis Nodosa. The American journal of medicine, 130(7), 796–798. https://doi.org/10.1016/j.amjmed.2017.02.006
Puéchal, X., Pagnoux, C., Baron, G., Quémeneur, T., Néel, A., Agard, C., Lifermann, F., Liozon, E., Ruivard, M., Godmer, P., Limal, N., Mékinian, A., Papo, T., Ruppert, A. M., Bourgarit, A., Bienvenu, B., Geffray, L., Saraux, J. L., Diot, E., Crestani, B.,… French Vasculitis Study Group (2017). Adding Azathioprine to Remission-Induction Glucocorticoids for Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss), Microscopic Polyangiitis, or Polyarteritis Nodosa Without Poor Prognosis Factors: A Randomized, Controlled Trial. Arthritis & Rheumatology, 69(11), 2175–2186. https://doi.org/10.1002/art.40205
Ribi, C., Cohen, P., Pagnoux, C., Mahr, A., Arène, J., Puéchal, X., Carli, P., Kyndt, X., Le Hello, C., Letellier, P., Cordier, J., Guillevin, L. & French Vasculitis Study Group (2010). Treatment of polyarteritis nodosa and microscopic polyangiitis without poor-prognosis factors: A prospective randomized study of one hundred twenty-four patients. Arthritis and rheumatism, 62(4), 1186–1197. https://doi.org/10.1002/art.27340
Ross, K., Contreras, J., Aung-Din, D. & Lien, M. (2017). Asymptomatic cutaneous polyarteritis nodosa: treatment options and therapeutic guidelines. Cutis, 100(2), 125–128.
Royero, D., Aristizábal, C., Dahbar, M., Sehman, A., Allevato, M. & Juárez, M. (2017). Cutaneous polyarteritis nodosa. Prensa Médica Argentina, 103(10), 541 - 545.
Sociedad Argentina de Reumatología (2016). PAN-poliarteritis nodosa. https://www.reumatologia.org.ar/enfermedades_reumaticas_detalle.php?IdEnfermedad=44
Schnappauf, O., Sampaio Moura, N., Aksentijevich, I., Stoffels, M., Ombrello, A., Hoffmann, P., Barron, K., Remmers, E., Hershfield, M., Kelly, S., NISC Comparative Sequencing Program, Cuthbertson, D., Carette, S., Chung, S., Forbess, L., Khalidi, N., Koening, C., Langford, C., McAlear, C., Monach, P.,… Vasculitis Clinical Research Consortium (2021). Sequence-Based Screening of Patients With Idiopathic Polyarteritis Nodosa, Granulomatosis With Polyangiitis, and Microscopic Polyangiitis for Deleterious Genetic Variants in ADA2. Arthritis y rheumatology, 73(3), 512–519. https://doi.org/10.1002/art.41549
Shiozaki, Y., Morita, K., Sawa, S., Saito, S. & Niinami, H. (2021). Coronary artery bypass using bilateral internal thoracic artery grafts in polyarteritis nodosa. Journal of cardiac surgery, 36(8), 2979–2981. https://doi.org/10.1111/jocs.15619
Terrier, B., Darbon, R., Durel, C., Hachulla, E., Karras, A., Maillard, H., Papo, T., Puechal, X., Pugnet, G., Quemeneur, T., Samson, M., Taille, C., Guillevin, L. & Collaborators (2020). French recommendations for the management of systemic necrotizing vasculitides (polyarteritis nodosa and ANCA-associated vasculitides). Orphanet journal of rare diseases, 15(Suppl 2), 351. https://doi.org/10.1186/s13023-020-01621-3
Vasculitis Foundation (12 de marzo del 2022). Poliarteritis nodosa, los fundamentos sobre esta enfermedad. https://www.vasculitisfoundation.org/education/forms/polyarteritisnodosa/#1545067203080-1bc729a9-8cf7
Wang, C. & Tsai, H. W. (2021). Human hepatitis viruses-associated cutaneous and systemic vasculitis. World journal of gastroenterology, 27(1), 19–36. https://doi.org/10.3748/wjg.v27.i1.19
Whelan, P. (2022). Clinical manifestations and diagnosis of rheumatoid vasculitis. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-rheumatoid-vasculitis
Zahoor, S., Siddique, S. & Mahboob, H. (2022). An unusual presentation of polyarteritis nodosa: A case report. Reumatología clínica, 18(2), 124–126. https://doi.org/10.1016/j.reumae.2020.08.010
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