• Yingying Ma, Luan Luan, Junjun Zhang, Chunfeng Ren, and Chunfeng Hou.
• Department of Rheumatology, Jining No. 1 People's Hospital, Jining, Shandong, China.
• Medicine (Baltimore). 2024 Aug 23; 103 (34): e39445e39445.

RationalePolyarteritis nodosa (PAN) is a necrotizing vasculitis that affects small- and medium-sized arteries, presenting with diverse clinical manifestations. It can impact tissues and organs throughout the body and may be life-threatening in severe cases. Common causes of death include cardiac, renal, and gastrointestinal complications or aneurysm rupture. While separate reports of renal aneurysm and intestinal perforation exist, the coexistence of these conditions is rarely documented. This study reports a severe case of PAN complicated by both renal aneurysm and intestinal perforation, aiming to deepen the understanding of this disease, aid in clinical diagnosis and treatment, and improve patient prognosis.Patient ConcernsThe patient presented to the hospital with dorsal foot pain and abdominal pain persisting for more than 4 months, along with pain and discomfort in both lower extremities for over 1 month.InterventionsThe patient was diagnosed with PAN, renal aneurysm, intestinal perforation, and grade 3 hypertension (high risk).OutcomesAfter treatment, the patient showed normal temperature and blood pressure, relief from abdominal pain, and disappearance of myalgia and numbness in the lower limbs. Additionally, the renal aneurysm shrank significantly, the intestinal perforation healed, the ileostomy was reduced, and the patient's condition stabilized.LessonsThe clinical symptoms of PAN mostly lack specificity, and should be distinguished from microscopic polyangiitis and simulated vasculitis. For patients with intestinal perforation similar to this case, tocilizumab treatment may be effective, but further research is needed to confirm it.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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