腎周囲血腫を来した結節性多発動脈炎に対し動脈塞栓術を施行した1例

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Polyarteritis nodosa (PN) is a necrotizing vasculitis that may affect multiple organ systems. We report a case of man with spontaneous perirenal hematoma due to the rupture of microaneurysms of the left kidney. Left renal arteriography showed many bleeding sites arising from ruptured microaneurysms; this finding along with the other clinical symptoms led to the final diagnosis. The ruptured lesions were embolized by coiling successfully, and oral corticosteroid resulted in the alleviation of the clinical symptoms. Left acute pyelonephritis developed due to ureteral calculi, leading to a non-functioning kidney; therefore, surgical resection was carried out 8 months after the initiation of corticosteroid therapy. Pathologic examination of the surgical specimen showed segmental interruption of the arterial elastic laminae and microaneurysms, suggesting healed stage of PN, although it failed to reveal features of fibrinoid vasculitis.
一般社団法人日本インターベンショナルラジオロジー学会の論文