Clinical Image: Isolated arteritis of the superior mesenteric artery with positive perinuclear antineutrophil cytoplasmic antibody
✍ Scribed by Frank Buttgereit; Wolfram Wermke; Falk Hiepe; Gerd-Rüdiger Burmester
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 211 KB
- Volume
- 41
- Category
- Article
- ISSN
- 0004-3591
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✦ Synopsis
Clinical Image: Isolated arteritis of the superior mesenteric arteiy with positive perinuclear antineutrophil cytoplasmic antibody
The patient, a 40-year-old man, presented with a 10-day history of fever, mild abdominal pain, diarrhea, and general weakness. Physical examination findings on admission were unremarkable apart from moderate abdominal pain in the left upper quadrant. Laboratory investigations revealed signs of acute inflammation, but no evidence of an underlying infection. However, perinuclear antineutrophil cytoplasmic antibodics were detected, and computed tomography scans revealed an isolated arteritis of the superior mesenteric artcry with circumferential wall thickening (A) (arrow). The vasa vasorum and the perfusion of the arterial wall as studied by power doppler showed remarkable signs of inflammatory hyperemia (B). Surprisingly, the results of intraarterial angiography were normal: duc to a smooth intraluminal surface and a predominantly extraluminal thickening of the vessel wall. Immunosuppressive treatment resulted in prompt disappearance of the clinical and laboratory signs.