PAN's labyrinth: a multidisciplinary delayed diagnosis and patient's perspective

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

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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:	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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