Polyarteritis Nodosa Case Study

Peripheral Arterial Disease is a common secondary disease that follows Atherosclerosis. Once so much plaque builds up in the arteries, they become block the blood flow. P.A.D. usually affects the lower extremities and can cause intermittent claudication and, if severe enough, gangrene. Many people live with atherosclerosis and P.A.D. and show no symptoms. There are numerous prevention methods for P.A.D that is similar to preventing any cardiovascular disease. Maintaining a healthy lifestyle is by far, the best form of prevention.

Polymyositis is characterized by progressive muscle weakness that usually starts in those muscles closest to the body’s trunk (i.e. proximal muscles). Other features of the disease may also include difficulty in swallowing and speaking (dysphagia and dysarthria, respectively), shortness of breath, heart beat irregularities and arthritis. In some cases as the disease progresses, the muscles that are furthest away from the trunk of the body (i.e. distal muscles), such as those in the forearms and ankles, may become affected. Furthermore, patients may have other symptoms including but not limited to a low-grade fever and peripheral adenopathy (enlargement of lymph nodes).

His hematocrit is 52% which is elevated from the normal 45% in men. The polycythemia occurs due to the presence of hypoxemia due to his COPD. The body will produce more red blood cells to attempt to increase the amount of O2 being delivered to the body tissue.

Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small

Laboratory: CK 41, aldose 5.7, CCP 5, rheumatoid factor 10.8, ANA negative, ANCA is less than 1:20, P-ANCA less than 1:20, hypersensitivity pneumonitis panel is negative, anti-Jo-1 is less than 0.2, scleroderma antibody is less than 0.2, IDE total 5. CBC within normal limits.

This lower extremities are most commonly affected. Atherosclerosis, Buerger disease and chronic venous insufficiency are some of the conditions that are connected with PVD. Atherosclerosis is the accumulation of plaque made of cholesterol, fat, cellular waste, fibrin and calcium which narrows or blocks the peripheral arteries and it is the most frequent condition that causes PAD. Whereas, venous insufficiency is an obstruction in the flow of deoxygenated blood form the lower extremities to the heart. This is due to weakening or damage to the veins. A nurse assessing a patient with venous insufficiency will find skin and angle discoloration, edema in the legs, heaviness and cramping in the legs and pain described as dull and aching. Buerger disease also known as thromboangiitis obliterans is a chronic inflammation of the arteries. This inflammation causes an obstruction in the small and medium arteries of the arms and legs due to blood clot. Buerger disease symptoms are cool clammy skin, reduced or absent sense of heat and cold along with pain in the legs or feet (hopkinsmedicine.org). The nurse will inform the patient that although Buerger disease causes pain in the leg, PAD causes intermittent pain in the leg which this patient is

Mononeuritis multiplex is asymmetric, sensory and motor peripheral neuropathy. Mononeuritis multiplex is not as frequent as in adults (3); cutaneous and neurological involvements of the extremities were present in our patient as previously described by Kawakami and friends (18). Albahri et al. reported 17 year old Czech girl who had hypoesthesia and paresthesia with a progressive right tibioperoneal nerve paresis, after the two years of disease could successfully conduct her activities of daily life but she had minor paresis (19). Our patient had severe pain and sensorimotor neuropathy in all extremities at admission, after pulse methylprednisolone complaint of pain reduced but slightly improvement in glove socks type sensory loss was seen.

Exclusion criteria: 1) Age above 65 years and less than 45 years, 2) Knee osteoarthritis with grade 0 and 1 and 4 the criteria of the Kellgren criteria, 3) secondary osteoarthritis (due to trauma), 4) Knee arthroscopic surgery in less than 6 months of the study, 5) Knee corticosteroids injection with less than 6 months of the project or during of project, 6) Exist of other chronic inflammatory process, 7) History of allergy to any of the compounds used in the study, 8) Patients with coagulation disorders and history of coronary disease, 9) Patients treated with drugs that affect coagulation process:

Relapsing polychondritis is thought to be a rare auto immune disease. While reading articles and research I found that those with relapsing polychondritis had antibodies against type II collagen and in increase in HLA-DR4 antigen which gives insight to the etiology of the disease. An abundance of research is done by case studies and mouse/rat models. A patient has increased erythrocyte sedimentation rate and C reactive protein as well as leukocyctosis, thrombocytosis, chronic anemia, and high levels of alpha and gamma globulins. CD4 T cells are at the site of inflammation which indicate cartilage as the target. They also have low levels of antinuclear antibody and antineutrophil cytoplasmic antibodies. The disease’s severity can vary

Whenever I was diagnosed with my Juvenile Rheumatoid Polyarticular Arthritis (JRA-P), I was 7 years old. My exercise routine was started a few years post-diagnosis, with a club swim team. This I continued for many years, flare in and flare out, through my junior year in high school. My experiences in swim were frustrating at many times because of my diagnosis, I never had an average time for my age group, even if I improved at a rapid pace.

A large vessel essentially refers to the aorta and its largest branches that are directed to the head and neck and the extremities. The hallmark in terms of pathology with large vessel vasculitides is that chronic inflammatory lesions are primarily found inside of the walls of vessels and not on the outside. This is a key distinction that can be used in order to separate large vessel from small vessel pathologies, which present with inflammation on the outside of the vessel wall in addition to being found within. The two main large artery vasculitides that will be discussed below are giant cell arteritis (GCA) and Takayasu disease.

The main aetiology of PVD is atherosclerosis and associated thrombo-embolism. Atherosclerosis is the gradual accumulation of lipids in the endothelium of peripheral artery causing atherosclerotic plaques. Atherosclerotic lesion can develop over atherosclerotic plaques and rupture, inducing thrombin generation, aggregation of platelet other extracellular matrix leading to thrombus formation or embolus. Atherosclerosis causes partial or complete occlusion and stenosis of the peripheral arteries. Other causes of PVD include limb injury, abnormal muscle and ligament structures, vasculitis, diabetes, and infection.

The echinococcus granulosus has been described as the most frequent cause of the hydatid cysts. Humans are the incidental intermediate host. Larvae emerge from the eggs in the intestine; and after invasion to the blood vessels, they can migrate into almost every part of the body.The usual destination is the liver via the portal tract, but sometimes the larvae pass through the liver barrier and reach the lungs and all the other viscera, where they transform into small cysts.The cyst of echinococcus is a rare finding in pelvic sites.Dissemination via lymphatic or systemic circulation has been implicated as a possible route to produce primary hydatid diseases outside the liver and lung.. In our case the ovarian hydatid cyst is most probably a secondary one, due to a spontaneously or iatrogenic rupture of the hepatic cyst removed 3 years earlier. Pelvic echinococcosis symptomatology is non-specific and can include abdominal tumefactions, abdominal pain, menstruation irregularities, infertility and urinary disturbances. Ovarian echinococcosis can simulate either polycystic disease or malignancy.. On USG, it mimics cystic ovarian disease or a solid ovarian mass.A high grade of suspicion or a preoperative diagnosis of echinococcus cyst makes it possible to avoid an intraoperative iatrogenic rupture, and when available, to administer previously an

Inflammation is “a condition in which a part of your body becomes red, swollen, and painful.” The two most common causes of inflammation are injury and illness, which the body responds to by producing C-reactive protein (CRP). By using Cue’s Sample Wand to collect a drop of blood, individuals can measure what many experts believe is the best overall marker of inflammation.

Thus, testing for ANA or ANA-specific autoantibodies have been incorporated in a number diagnostic criteria. For example, a positive ANA finding was incorporated as a diagnostic criterion for SLE [18, 19]. In 2013, a joint committee of the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) formulated a new set of SSc classification criteria which included the ANA-specific autoantibodies, namely; anti-topoisomerase I (anti-topo I or anti-Scl-70), anti-centromere (ACA), and anti-RNA polymerase III (anti-RNAP III [20].