Dr. Ketan H. Shah*
Consulting Pediatrician, Surat *
|Cutaneous Polyarteritis is rare vasculitides of childhood. Polyarteritis nodosa and related entity are infrequently seen in pediatric age group. Distinction amongst this related entity is also difficult. We report a case of Cutaneous Polyarteritis (CPA) in 16 months, female child. She had benign course.
Patient A//18 months/female has presented to us with H/o antecedent respiratory tract infection 15 days back, followed by cutaneous lesion, fever, joint swelling. She has developed edema of foot and swelling on ankle joint. Cutaneous lesions were in the form of subcutaneous nodules having bluish back color. No purpuric lesions or ulceration. Fever was low grade for 5 days and than subsided. Her BP was within normal percentile thru out the disease course. Subcutaneous nodules were multiple on lower limb and few on upper limb.
Lab. Investigations showed high WBC count with elevated ESR, positive CRP. Her RF, ANA, ANCA, (IIF) HIV, HBsAg tests were negative. Her RFT, LFT was normal. Urine examination did not reveal any abnormality. Angiography of renal vessels and coronary vessels was normal. The disease lasted for around 15 days. She was treated symptomatically.
Looking to clinical features and lab parameters, diagnosis of cutaneous vasculitis was kept. She had subcutaneous nodules, arthritis, fever and myalgia. This favors diagnosis of CPA. Polyarteritis nodosa has more fulminate course with multisystem involvement and positive HBsAg. In our case multi-system involvement was not there. Kumar et al from India has reported 10 cases in age group of 1-10 years in 1995 benign nature and good outcome makes this entity distinct in vasculitidies group.
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|Shah H K D.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=331|