Iatreia (Apr 2022)

Demographic and clinical profile of systemic and cutaneous Polyarteritis nodosa in a group of pediatric patients in Medellin, 2010-2019

  • Medina, Ana María,
  • Calle, Mateo,
  • Eraso-Garnica, Ruth,
  • Peinado-Acevedo, Juan Sebastián,
  • Vanegas-García, Adriana Lucía,
  • Jaramillo-Arroyave, Daniel ,
  • Muñoz-Vahos, Carlos Horacio,
  • Hernández-Zapata, Lady Johanna

DOI
https://doi.org/10.17533/udea.iatreia.122
Journal volume & issue
Vol. 35, no. 2
pp. 108 – 116

Abstract

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Objective: To describe the main demographic and clinical characteristics of patients who were diagnosed with childhood polyarteritis nodosa (PAN). Methods: A descriptive study was conducted using retrospective data. Results: The clinical registries from patients under 18th years with vasculitis or PAN diagnosis attended between 2010 and 2019 in two Medical Centers from Medellín were obtained. Nineteen patients were included: eleven classified as cutaneous PAN (PANC) accor-ding to the definition of the European League Against Rheumatism and the European Society of Pediatric Rheumatology and eight as systemic PAN according to Ankara 2008 Criteria. 57.9% were male. The median age at diagnosis was ten years (3-17), and the median follow-up period was 15 months (0-105). The most common clinical characteristics were subcutaneous nodules (84.2%), fever (57.9%), arthralgias (57.9%), and calf pain (52.6%). SPAN patients had more frequent weight loss and lower hemoglobin. Five patients had ulcers (26.3%), four of them with CPAN; two patients had lingual necrosis (10.5%), and two digital necrosis (10.5%), all of them also with CPAN. CRP mean was 10.2 mg/dl (0.33-45.3) and mean erythrocyte sedi-mentation rate (ESR) was 74 mm/h (15-127 mm/h). Meningeal enhancing, intrahepatic, and mesenteric aneurism, among others, were reported in diagnostic images. All patients required treatment with systemic glucocorticoid. None of the patients died during the follow-up period. Conclusions: In this pediatric series from Medellín-Colombia, PAN was more common in boys of school age. CPAN was more frequent than SPAN. The clinical characteristics most reported were subcutaneous no-dules, myalgias, arthralgias, and calf pain. Although CPAN has been considered a benign disease, these patients may require systemic glucocorticoid and immunosuppressive therapy.

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