Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-19T20:05:23.820Z Has data issue: false hasContentIssue false

Convergence Paralysis as a Manifestation of Polyarteritis Nodosa

Published online by Cambridge University Press:  02 December 2014

Jessica Wylie
Affiliation:
Department of Pediatrics, London Health Sciences Centre, University of Western Ontario, London, ON
Craig Campbell*
Affiliation:
Department of Pediatrics, London Health Sciences Centre, University of Western Ontario, London, ON
Janet Pope
Affiliation:
Department of Rheumatology, London Health Sciences Centre, University of Western Ontario, London, ON
Jonathan Akikusa
Affiliation:
Department of Rheumatology, Pediatrics and Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Ronald M. Laxer
Affiliation:
Department of Rheumatology, Pediatrics and Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Dave Nicolle
Affiliation:
Department of Ophthalmology, London Health Sciences Centre, University of Western Ontario, London, ON
*
Section of Pediatric Neurology, Children’s Hospital of Western Ontario, 800 Commissioners Rd. E., London, Ontario N6A 2E3, Canada
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Polyarteritis nodosa (PAN) is a rare, systemic necrotizing vasculitis of medium-sized arteries. The American College of Rheumatology criteria for the diagnosis of PAN includes at least three of: 1. weight loss < 4 kg, 2. livedo reticularis, 3. testicular pain or tenderness, 4. myalgias, weakness or leg tenderness, 5. mono-or polyneuropathy, 6. diastolic hypertension, 7. elevated blood creatinine or urea, 8. hepatitis B antigen or antibody in the serum, 9. aneurysms or occlusions of visceral arteries or 10. granulocytes on small or medium sized artery biopsy. Common sites of involvement include skin, joints, kidneys, gastrointestinal tract and peripheral nerves. Central nervous system involvement has been reported in up to 40% of cases; the usual manifestations are encephalopathy, focal deficits and seizures. Descriptions of PAN in the pediatric literature has been reported in fewer than 250 children.

Type
Peer Reviewed Letter
Copyright
Copyright © The Canadian Journal of Neurological 2006

References

1. Lightfoot, RW Jr, Michel, BA, Bloch, DA, Hunder, GG, Zvaifler, NJ, McShane, DJ. The ACR 1990 criteria for the classification of PAN. Arthritis Rheum. 1990; 33: 108893.CrossRefGoogle Scholar
2. Moore, PM, Fauci, AS. Neurologic manifestations of systemic vasculitis. A retrospective and prospective study of the clinicopathologic features and responses to therapy in 25 patients. Am J Med Sci. 1981; 71: 51724.Google Scholar
3. Sundel, R, Szer, I. Vasculitis in Childhood. Rheum Dis Clin North Am. 2002; 28: 62554.CrossRefGoogle ScholarPubMed
4. Greenberg, D, Aminoff, M, Simon, R. Disorders of equilibrium. In: Foltin, J, Liebowitz, H, Kurtz, S, Panton, N, editors. Clinical Neurology. New York: McGraw Hill; 2002. p. 115.Google Scholar
5. Brazis, P, Lee, A. Acquired Binocular Horizontal Diplopia. Mayo Clin Proc. 1999; 74: 90716.Google Scholar
6. Ford, RG, Siekert, RG. Central nervous system manifestations of periarteritis nodosa. Neurology. 1965; 15: 11422.CrossRefGoogle ScholarPubMed
7. Guillevin, L, Le, THD, Godeau, P, Jais, P, Wechsler, B. Clinical findings and prognosis of polyarteritis nodosa and Churg-Strauss angiitis: a study in 165 patients. Br J Rheumatol. 1988; 27: 25864.Google Scholar
8. Provenzale, J, Allen, N. Neuroradiologic findings in Polyarteritis Nodosa. Am J Neuroradiol. 1996; 17: 111926.Google Scholar
9. Guillevin, L, Fancois, L, Gherardi, R. Polyarteritis Nodosa, Microscopic Polyangiitis, and Churg-Strauss syndrome: clinical aspects, neurologic manifestations and treatment. Neurol Clin. 1997; 15: 86586.Google Scholar
10. Bouche, P, Leger, JM, Travers, MA, Cathala, HP, Castaigne, P. Peripheral neuropathy in systemic vasculitis: clinical and electrophysiologic study of 22 patients. Neurology. 1986; 36: 1598602.Google Scholar
11. Moore, P, Richardson, B. Neurology of the vasculitides and connective tissue diseases. J Neurol Neurosurg Psychiatry. 1998; 65: 1022.CrossRefGoogle ScholarPubMed
12. Ozen, S, Anton, J, Arisoy, N, Bakkalodlu, A, Besbas, N, Brogan, P, et al. Juvenile polyarteritis: results of a multicenter survey of 110 children. J Pediatr. 2004; 145:51722.Google Scholar
13. Ozen, S, Besbas, N, Saatci, U, Bakkaloglu, A. Diagnostic criteria for Polyarteritis Nodosa in childhood. J Pediatr. 1992; 120: 2069.Google Scholar
14. Fink, C. Vasculitis. Pediatr Clin North Am. 1986; 33: 120319.Google Scholar
15. Ragge, NK, Harris, CM, Dillon, MJ, Chong, WK, Elston, J, Taylor, D. Ocular tilt reaction due to a mesencephalic lesion in juvenile Polyarteritis Nodosa. Am J Ophthalmol. 2003; 135: 24951.Google Scholar
16. Schrodt, B, Callen, J. Polyarteritis Nodosa attributable to minocycline treatment for acne vulgaris. Pediatrics. 1999; 103: 5034.CrossRefGoogle ScholarPubMed
17. Elkayam, O, Yaron, M, Caspi, D. Minocycline induced arthritis associated with fever, livedo reticularis, and p-ANCA. Ann Rheum Dis. 1996; 55: 76971.Google Scholar