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首页> 外文期刊>Nature clinical practice:Urology >A case of systemic polyarteritis nodosa with spermatic cord involvement.
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A case of systemic polyarteritis nodosa with spermatic cord involvement.

机译：一例结节性多发性动脉炎伴精索受累。

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BACKGROUND: A 50-year-old man with a history of hyperlipidemia and hypertension presented to an emergency department after 10 days of fevers (temperature 40 degrees C), headache, malaise, myalgia, poor appetite, diarrhea, and weight loss of 6.35 kg. He would subsequently develop bilateral scrotal swelling and pain during his evaluation. INVESTIGATIONS: Physical examination, CBC, blood chemistry panel, measurement of erythrocyte sedimentation rate and C-reactive protein level, liver function profile, urinalysis, lumbar puncture, blood cultures, urine cultures, cerebrospinal fluid culture, stool analysis and cultures, multiple viral studies including hepatitis serologies, measurement of antineutrophil cytoplasmic autoantibody levels, urine protein electrophoresis, serum protein electrophoresis, CT of the head, chest, abdomen and pelvis, MRI of the brain, temporal artery biopsy and pathologic analysis, scrotal ultrasonography, right spermatic cord biopsy and pathologic analysis. DIAGNOSIS: Polyarteritis nodosa with involvement of both spermatic cords. MANAGEMENT: Prednisone 60 mg daily was started for presumed temporal arteritis, but was discontinued when no evidence of arteritis was found in the temporal artery biopsy specimen. When pathologic analysis of the spermatic cord biopsy tissue confirmed polyarteritis nodosa, prednisone 40 mg twice daily was administered and the patient's scrotal pain and swelling resolved quickly. Steroids were slowly tapered and discontinued over the next 18 months. He remained free of systemic symptoms, with normal results on physical examination and laboratory evaluation, including urinalysis, CBC, erythrocyte sedimentation rate and C-reactive protein level, 5.5 months after discontinuation of glucocorticoid therapy.
机译：背景：一名患有高脂血症和高血压病史的50岁男子在发烧（温度40摄氏度），头痛，全身乏力，肌痛，食欲不振，腹泻和体重减轻6.35千克10天后出现急诊科。随后，他在评估期间会出现双侧阴囊肿胀和疼痛。调查：体格检查，CBC，血液化学小组，红细胞沉降率和C反应蛋白水平的测量，肝功能状况，尿液分析，腰椎穿刺，血液培养，尿培养，脑脊液培养，粪便分析和培养，多次病毒研究包括肝炎血清学检查，抗中性粒细胞胞浆自身抗体水平的测量，尿蛋白电泳，血清蛋白电泳，头部，胸部，腹部和骨盆的CT扫描，脑部MRI，颞动脉活检和病理分析，阴囊超声检查，右精索活检和病理分析。诊断：结节性多发性动脉炎同时累及两个精索。处理：假定的颞动脉炎开始使用泼尼松每日60 mg，但在颞动脉活检标本中未发现动脉炎的证据时，停用该药。当对精索活检组织进行病理分析确认结节性多发性动脉炎时，强的松40 mg每天给药两次，患者的阴囊痛和肿胀迅速消失。类固醇逐渐变细，并在接下来的18个月内停产。停止糖皮质激素治疗5.5个月后，他仍未出现全身症状，身体检查和实验室评估结果均正常，包括尿液分析，CBC，红细胞沉降率和C反应蛋白水平。

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