Polyarteritis, microscopic

Rashes or other aUergic-tjrpe cutaneous reactions are usually noted during the azathioprine hypersensitivity syndrome. Isolated but convincing reports point to the occurrence of vasculitis with microscopic polyarteritis (SEDA-21, 381) and Sweet s syndrome, which recurred after subsequent azathioprine exposure (SEDA-22, 410). 

Two cases of biopsy-proven cutaneous polyarteritis nodosa with positive perinuclear antineutrophilic cytoplasmic antibodies have been reported with long-term use of minocycline for acne vulgaris (50-100 mg/day for 44 months and 100 mg/day for 65 months) (52). In one of the cases, involvement was not restricted to medium-size vessels alone. In both cases the vasculitis disappeared after a short course of prednisone (40 mg/day) and withdrawal of minocycline. Rechallenge was not performed. P-ANCA is usually found in microscopic poly angiitis, a vasculitis of smaller arteries, and its significance in polyarteritis nodosa is not clear. 

FIGURE 25.1 Stages in the development of preclinical DIVI. Zhang and colleagues (2008) used the term polyarteritis nodosa in this manuscript to reflect the microscopic finding of necrotizing inflammation, fibrous thickening of arterial walls, and nodular fibroblastic prohferation in the adventitia. ... 

Siebels et al. (1993) presented case histories of five patients with silicosis who had developed systemic LE and microscopic polyarteritis in two cases each, and rapidly progressive glomerulonephritis (limited Wegener s granulomatosis) in one case. Recently, a male patient who had worked as a stone cutter and had developed silicosis and systemic LE was also reported by Siebels et al. (1995). 

Akikusa B, Kondo Y, Irabu N, et al. Six cases of microscopic polyarteritis exhibiting acute interstitial pneumonia. Pathol Int 1995 45(8) 580-588. 

Mohammad AJ, Jacobsson LT, Mahr AD, et al. Prevalence of Wegener s granulomatosis, microscopic polyangiitis, polyarteritis nodosa and Churg-Strauss syndrome within a defined population in southern Sweden. Rheumatology (Oxford) 2007 46(8) 1329-1337. 

Mahr A, Guillevin L, Poissonnet M, et al. Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener s granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000 a capture-recapture estimate. Arthritis Rheum 2004 51(l) 92-99. 

Savage CO, Winearls CG, Turner DR et al (1985) Microscopic polyarteritis presentation, pathology and prognosis. Q J Med 56 467-483... 

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