A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs of last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side. On examination, BP was 160/140 mm Hg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed a Hb 12 gm, TLC -- 12000 Cu mm, Platelets 430,000; ESR -- 49 mm. Urine examination showed proteinuria and RBC -- 10-15/hpf with no casts. Which of the following is the most likely diagnosis?
High-Yield Explanation
In PAN, there is development of digital infarcts even in the presence of good peripheral pulses. Hypeension is due to involvement of renal aeries. Ref : Harrison's Principles of Internal Medicine 21st ed