| Barlow, Emma, Seddon, O. and Healy, B. 2016. PAN's labyrinth: a multidisciplinary delayed diagnosis and patient's perspective. BMJ Case Reports 2016 , bcr2015213495. 10.1136/bcr-2015-213495 |
Abstract
Polyarteritis nodosa (PAN) is a rare, severe form of vasculitis affecting medium-sized vessels. It manifests as a multisystem syndrome, and may be associated with hepatitis B virus-associated PAN (HBV-PAN) although the incidence of this is declining with better vaccination strategies and awareness of bloodborne virus screening. We report a case in which a patient displayed many classical features of the disease, occurring separately over a period of months and leading to contact with various medical specialties. Managing each symptom in isolation led to a number of misdiagnoses (including testicular cancer) and the patient experienced considerable psychological stress and morbidity as a result. The case was complicated by acute pancreatitis developing after an initial treatment response. This may have been iatrogenic (as a consequence of either entecavir or steroids) or secondary to PAN. For our patient, this led to a protracted clinical course but eventual complete resolution of both pathologies.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Schools > Medicine |
| Publisher: | BMJ Publishing Group Ltd |
| ISSN: | 1757-790X |
| Date of Acceptance: | 12 December 2015 |
| Last Modified: | 07 Dec 2019 03:33 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/101792 |
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