• Victoria Pașa, Elena Popa, Mihaela Poroch, Adriana Cosmescu, Agnes Iacinta Bacusca, Ana Maria Slanina, Alexandr Ceasovschih, Alexandra Stoica, Antoneta Petroaie, Monica Ungureanu, Andrei Emilian Popa, Raluca Ioana Avram, Cristina Bologa, Vladimir Poroch, and Elena Adorata Coman.
• 2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania.
• Medicina (Kaunas). 2023 Jun 16; 59 (6).

AbstractClassic polyarteritis nodosa (PAN) is a vasculitis with systemic manifestations that is characterized by inflammatory and necrotizing lesions affecting medium and small muscular arteries, most frequently at the bifurcation of the vessels. These lesions lead to the formation of microaneurysms, hemorrhaging ruptured aneurysms, thrombosis, and, consequently, ischemia or organ infarction. Background and Objectives: We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement. Materials and Methods: The 44-year-old patient, in an urban environment, presented on her own in the emergency room for acute ischemia phenomena and forearm and right-hand compartment syndrome, requiring surgical decompression in the Plastic Surgery Clinic. Results: Significant inflammatory syndrome is noted, alongside severe normocytic hypochromic iron deficiency anemia, nitrogen retention syndrome, hyperkalemia, hepatic syndrome, and immunological disturbances: absence of cANCA, pANCA, anti Scl 70 Ac, antinuclear Ac, and anti dDNA Ac, as well as a low C3 fraction of the plasmatic complement system. The morphological aspect described in the right-hand skin biopsy correlated with the clinical data supports the diagnosis of PAN. Conclusions: The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.

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