ab17_2

Primary polyarteritis nodosa presenting as acute symmetric quadriplegia

X. Bosch, M. Navarro, A. Lopez-Soto¹, J.M. Grau¹, F. Martinez-Orozco

Internal Medicine Unit, Hospital Casa Maternitat, Corporació Sanitària Clínic; ¹General Internal Medicine Department, Hospital Clínic i Provincial, Corporació Sanitària Clínic, University of Barcelona, Barcelona, Spain.

ABSTRACT
We report a case of peripheral neuropathy presenting as acute symmetric areflexic quadriplegia in the setting of a well-defined clinical, histopathologic, and angiographic diagnosis of classic polyarteritis nodosa.
While it is usually easy to recognize the typical clinical presentation of necrotizing angiopathy-induced peripheral neuropathy as a mononeuritis multiplex or a distal polyneuropathy in association with a collagen vascular disease, clinicians must be equally sensitive to a number of more challenging possibilities. Acute quadriplegia similar to that seen in Guillain-Barré syndrome can be secondary to primary classic polyarteritis nodosa and the former may be the chief or even the sole manifestation of the latter.

Key words
Polyarteritis nodosa, polyneuropathy, quadriplegia, peripheral neuropathy, vasculitis.

Please address correspondence and requests for reprints to: Dr. Xavier Bosch, Unitat de Medicina Interna, Hospital Casa Maternitat, Sabino de Arana no. 1, 08028 Barcelona, Spain.