Mycophenolate mofetil in the treatment of childhood systemic polyarteritis nodosa

被引:0
作者
Bhattarai, Dharmagat [1 ]
Banday, Aaqib Zaffar [2 ]
Nori, Harshita [2 ]
Gupta, Anju [2 ]
机构
[1] Om Hosp & Res Ctr, Pediat, Kathmandu, Bagmati, Nepal
[2] Post Grad Inst Med Educ & Res, Pediat, Chandigarh, India
关键词
vasculitis; drugs; musculoskeletal and joint diseases; musculoskeletal syndromes;
D O I
10.1136/bcr-2021-248477
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Polyarteritis nodosa (PAN) is a medium vessel vasculitis with necrotising vascular changes along with multisystemic involvement. Due to variable initial presentations, diagnosis of systemic PAN in children requires a comprehensive work up. In addition, systemic PAN needs an aggressive therapy. Mycophenolate mofetil is an emerging newer alternative for the treatment of PAN. We report a case of childhood systemic PAN who initially presented with subtle signs like reduced sensation over lateral foot, non-deforming arthritis and multiform rashes. After comprehensive aetiological work up, nerve biopsy and supporting evidence clinched the diagnosis. Vasculitis in children presenting with benign subtle signs is sometimes a diagnostic challenge to clinicians. Our case highlights the importance of lateral thinking while dealing with non-specific multisystemic signs. Evidence of successful treatment of PAN with mycophenolate mofetil is gradually being built up. It is also described to result lower relapse and increased treatment free survival rate.
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页数:3
相关论文
共 7 条
[1]   Mycophenolate Mofetil Versus Cyclophosphamide for Remission Induction in Childhood Polyarteritis Nodosa: An Open-Label, Randomized, Bayesian Noninferiority Trial [J].
Brogan, Paul A. ;
Arch, Barbara ;
Hickey, Helen ;
Anton, Jordi ;
Iglesias, Este ;
Baildam, Eileen ;
Mahmood, Kamran ;
Cleary, Gavin ;
Moraitis, Elena ;
Papadopoulou, Charalampia ;
Beresford, Michael W. ;
Riley, Phil ;
Demir, Selcan ;
Ozen, Seza ;
Culeddu, Giovanna ;
Hughes, Dyfrig A. ;
Dolezalova, Pavla ;
Hampson, Lisa, V ;
Whitehead, John ;
Jayne, David ;
Ruperto, Nicola ;
Eleftheriou, Despina .
ARTHRITIS & RHEUMATOLOGY, 2021, 73 (09) :1673-1682
[2]   Systematic review of childhood-onset polyarteritis nodosa and DADA2 [J].
Cuceoglu, Muserref Kasap ;
Sener, Seher ;
Batu, Ezgi Deniz ;
Akca, Ummusen Kaya ;
Demir, Selcan ;
Sag, Erdal ;
Atalay, Erdal ;
Bal, Zeynep ;
Basaran, Ozge ;
Bilginer, Yelda ;
Ozen, Seza .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 2021, 51 (03) :559-564
[3]   European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides - the SHARE initiative [J].
de Graeff, Nienke ;
Groot, Noortje ;
Brogan, Paul ;
Ozen, Seza ;
Avcin, Tadej ;
Bader-Meunier, Brigitte ;
Dolezalova, Pavla ;
Feldman, Brian M. ;
Kone-Paut, Isabelle ;
Lahdenne, Pekka ;
Marks, Stephen D. ;
McCann, Liza ;
Pilkington, Clarissa ;
Ravelli, Angelo ;
van Royen, Annet ;
Uziel, Yosef ;
Vastert, Bas ;
Wulffraat, Nico ;
Kamphuis, Sylvia ;
Beresford, Michael W. .
RHEUMATOLOGY, 2019, 58 (04) :656-671
[4]   Comparing polyarteritis nodosa in children and adults: a single center study [J].
Erden, Abdulsamet ;
Batu, Ezgi D. ;
Sonmez, Hafize E. ;
Sari, Alper ;
Armagan, Berkan ;
Arici, Zehra S. ;
Bilgin, Emre ;
Kalyoncu, Umut ;
Karadag, Omer ;
Bilginer, Yelda ;
Ertenli, Ali Ihsan ;
Ozen, Seza .
INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, 2017, 20 (08) :1016-1022
[5]   Childhood- versus Adult-Onset Polyarteritis Nodosa Results from the French Vasculitis Study Group Registry [J].
Iudici, Michele ;
Quartier, Pierre ;
Pagnoux, Christian ;
Merlin, Etienne ;
Agard, Christian ;
Aouba, Achille ;
Roblot, Pascal ;
Cohen, Pascal ;
Terrier, Benjamin ;
Mouthon, Luc ;
Guillevin, Loic ;
Puechal, Xavier .
AUTOIMMUNITY REVIEWS, 2018, 17 (10) :984-989
[6]   Epidemiology of primary systemic vasculitis in children: a population-based study from southern Sweden [J].
Mossberg, M. ;
Segelmark, M. ;
Kahn, R. ;
Englund, M. ;
Mohammad, A. J. .
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, 2018, 47 (04) :295-302
[7]   EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria [J].
Ozen, Seza ;
Pistorio, Angela ;
Iusan, Silvia M. ;
Bakkaloglu, Aysin ;
Herlin, Troels ;
Brik, Riva ;
Buoncompagni, Antonella ;
Lazar, Calin ;
Bilge, Ilmay ;
Uziel, Yosef ;
Rigante, Donato ;
Cantarini, Luca ;
Hilario, Maria Odete ;
Silva, Clovis A. ;
Alegria, Mauricio ;
Norambuena, Ximena ;
Belot, Alexandre ;
Berkun, Yackov ;
Estrella, Amparo Ibanez ;
Olivieri, Alma Nunzia ;
Alpigiani, Maria Giannina ;
Rumba, Ingrida ;
Sztajnbok, Flavio ;
Tambic-Bukovac, Lana ;
Breda, Luciana ;
Al-Mayouf, Sulaiman ;
Mihaylova, Dimitrina ;
Chasnyk, Vyacheslav ;
Sengler, Claudia ;
Klein-Gitelman, Maria ;
Djeddi, Djamal ;
Nuno, Laura ;
Pruunsild, Chris ;
Brunner, Jurgen ;
Kondi, Anuela ;
Pagava, Karaman ;
Pederzoli, Silvia ;
Martini, Alberto ;
Ruperto, Nicolino .
ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (05) :798-806