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Medicine Immunology and Rheumatology 285124e1

A 39-year-old man has had several weeks of fever, weight loss, and lack of energy. Three days prior to the assessment, he developed a left foot drop. Physical examination confirms left peroneal nerve damage and a bilateral sensory peripheral neuropathy in both legs. Laboratory evaluation reveals ESR of 105 mm/h, neutrophilia of 14,000, and a negative serologic test for ANCA. Eosinophil count is normal. Angiography reveals small aneurysms of the celiac and renal arteries.For the above patient with vasculitis syndrome, select the most likely diagnosis.

A
polyarteritis nodosa (PAN)
B
Churg-Strauss disease
C
Henoch-Schonlein purpura
D
vasculitis associated with infectious diseases
High-Yield Explanation
PAN is a multisystem, necrotizing vasculitis of small-and medium-sized muscular arteries. Aneurysmal dilations of the arteries are characteristic. Nonspecific signs and symptoms are the usual method of presentation. Renal involvement is clinically present in 60% of cases and is the most common cause of death in untreated cases.

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