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Periarteritis Nodosa in Infancy FREE

Robert B. Benyo, MD; Eugene V. Perrin, MD
[+] Author Affiliations

Received for publication April 22, 1968.

Reprint requests to Institute of Pathology, Case Western Reserve University, 2085 Adelbert Rd, Cleveland 44106 (Dr. Benyo).


Am J Dis Child. 1968;116(5):539-544. doi:10.1001/archpedi.1968.02100020543017.
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ALTHOUGH periarteritis nodosa is being reported with increasing frequency, it is still an uncommon disease of infancy. There have been only 23 reported cases occurring during the first year of life.1-20 All have had similar clinical findings. A premortem diagnosis of periarteritis nodosa is rare, documented only once in the cases reviewed.20 An awareness of the signs and symptoms of this disease, however, may make a presumptive diagnosis possible during life with consequent initiation of proper treatment. Periarteritis nodosa in infants predominantly involves the coronary arteries and is associated with sudden, unexpected death.

Report of a Case  The patient was an 8-month-old white boy who was first seen by a private pediatrician because of fever and a nonspecific facial rash. He was treated with penicillin. The following day the patient's temperature increased to 106 F (41.1 C) and he had loose bowels, vomiting, and hoarseness. The physician treated

REFERENCES

Scott, E.P., and Rotondo, C.C.:  Periarteritis Nodosa , J Pediat 25:306-310 ( (Oct) ) 1944;.
Pickark, C.M.; Owen, J.G.; and Dammin, G.J.:  Aneurysms of the Coronary Arteries Due to Polyarteritis Nodosa in an Infant , J Lab Clin Med 32: 1513-1514 ( (Dec) ) 1947;.
Scott, E.P., and Miller, A.J.:  Coronary Thrombosis , J Pediat 28:478-482 ( (April) ) 1946;.
Sinclair, W., Jr., and Nitsche, E.:  Polyarteritis Nodosa of the Coronary Arteries , Amer Heart J 38: 898-904 (Dec) 1949;.
Adelson, L.:  Periarteritis Nodosa in Infancy , J Pediat 39:346-353 ( (Sept) ) 1951;.
Crocker, D.W.; Sobin, S.; and Thomas, W.C.:  Aneurysms of the Coronary Arteries , Amer J Path 33:819-843 ( (July) -Aug) 1957;.
Krzyszkowski, quoted by Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275-286, 1945;.
Fager, D.B.; Bigler, J.A.; and Simonds, J.P.:  Polyarteritis Nodosa in Infancy and Childhood , J Pediat 39:65-79 ( (July) ) 1951;.
Martelle, R.R.:  Coronary Thrombosis in a 5-Month-Old Infant , J Pediat 46:322-326 ( (March) ) 1955;.
Ramsay, R.E., and Crumrine, R.M.:  Coronary Thrombosis in an Infant Aged Four Months , Amer J Dis Child 42:107-110 ( (July) ) 1931;.
Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275-286, 1945;.
Thinnes, quoted by Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275, 1945;.
Liban, E.; Shamir, Z.; and Schorr, S.:  Periarteritis Nodosa in a Nine-Month-Old Infant , Amer J Dis Child 88:210-215 ( (Aug) ) 1954;.
Bohman, M.:  Periarteritis Nodosa in an Infant of Three Months , Acta Paediat 43:374-378 ( (July) ) 1954;.
Johansmann, R.J., and Zeek, P.:  Periarteritis Nodosa in a Week Old Infant , Arch Path 58:207-213 ( (Sept) ) 1954;.
Rose, G.A.:  The Natural History of Periarteritis , Brit Med J 2:1148-1152 ( (Nov) ) 1957;.
Munro-Faure, H.:  Necrotizing Arteritis of the Coronary Vessels in Infancy , Pediatrics 23:914-926 ( (May) ) 1959;.
Savage, T.R., and Smith, J.F.:  Polyarteritis Nodosa and Congenital Pyloric Hypertrophy in a 3-Month-Old Infant , J Clin Path 13:291-296 ( (July) ) 1960;.
Henry, M.J.; Stoeckle, H.G.E.; and Hopps, H.C.:  Periarteritis in a 4-Month-Old Infant Unresponsive to Penicillinase , Amer Heart J 60:817-822 ( (Nov) ) 1960;.
Roberts, F.B., and Fetterman, G.H.:  Polyarteritis Nodosa in Infancy , J Pediat 63:519-529 ( (Oct) ) 1963;.
Coppoletta, J.A., and Wolback, S.B.:  Body Length and Organ Weights of Infants and Children , Amer J Path 9:55-70 ( (Jan) ) 1933;.
Kambolis, K.P.; Lebhar, N.F.; and Barnett, R.N.:  Coronary Thrombosis and Myocardial Infarction in a 4½-Year-Old Boy , Pediatrics 22:135-144 ( (July) ) 1958;.
Knowles, H.C.; Zeek, P.M.; and Blankenhorn, M.A.:  Studies on Necrotizing Angiitis: IV. Periarteritis Nodosa and Hypersensitivity Angiitis , Arch Intern Med 92:789-805 ( (Dec) ) 1953;.
Zeek, P.M.; Smith, C.C.; and Weeter, J.C.:  Studies on Periarteritis Nodosa: III. The Differentiation Between the Vascular Lesions of Periarteritis Nodosa and of Hypersensitivity , Amer J Path 24:889-917 ( (July) ) 1948;.
Faber, H.K., and Rather, L.J.:  Sudden Death Due to Coronary Insufficiency Resulting From Healed Polyarteritis Nodosa in a Boy of Seven Years , Stanford Med Bull 18:10-20 ( (Feb) ) 1960;.
Diaz-Rivera, R.S., and Miller, A.J.:  Periarteritis Nodosa: A Clinical Pathological Analysis of Seven Cases , Ann Intern Med 24:420-443 ( (March) ) 1946;.
Rich, A.R., and Gregory, J.E.:  The Experimental Demonstration That Periarteritis Nodosa is a Manifestation of Hypersensitivity , Bull Hopkins Hosp 72:65-88, 1943;.
Zeek, P.M.:  Periarteritis Nodosa and Other Forms of Necrotizing Angiitis , New Eng J Med 248: 764-772 ( (April) ) 1953;.

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References

Scott, E.P., and Rotondo, C.C.:  Periarteritis Nodosa , J Pediat 25:306-310 ( (Oct) ) 1944;.
Pickark, C.M.; Owen, J.G.; and Dammin, G.J.:  Aneurysms of the Coronary Arteries Due to Polyarteritis Nodosa in an Infant , J Lab Clin Med 32: 1513-1514 ( (Dec) ) 1947;.
Scott, E.P., and Miller, A.J.:  Coronary Thrombosis , J Pediat 28:478-482 ( (April) ) 1946;.
Sinclair, W., Jr., and Nitsche, E.:  Polyarteritis Nodosa of the Coronary Arteries , Amer Heart J 38: 898-904 (Dec) 1949;.
Adelson, L.:  Periarteritis Nodosa in Infancy , J Pediat 39:346-353 ( (Sept) ) 1951;.
Crocker, D.W.; Sobin, S.; and Thomas, W.C.:  Aneurysms of the Coronary Arteries , Amer J Path 33:819-843 ( (July) -Aug) 1957;.
Krzyszkowski, quoted by Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275-286, 1945;.
Fager, D.B.; Bigler, J.A.; and Simonds, J.P.:  Polyarteritis Nodosa in Infancy and Childhood , J Pediat 39:65-79 ( (July) ) 1951;.
Martelle, R.R.:  Coronary Thrombosis in a 5-Month-Old Infant , J Pediat 46:322-326 ( (March) ) 1955;.
Ramsay, R.E., and Crumrine, R.M.:  Coronary Thrombosis in an Infant Aged Four Months , Amer J Dis Child 42:107-110 ( (July) ) 1931;.
Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275-286, 1945;.
Thinnes, quoted by Wilmer, H.A.:  Two Cases of Periarteritis Nodosa Occurring in the First Month of Life , Bull Hopkins Hosp 77:275, 1945;.
Liban, E.; Shamir, Z.; and Schorr, S.:  Periarteritis Nodosa in a Nine-Month-Old Infant , Amer J Dis Child 88:210-215 ( (Aug) ) 1954;.
Bohman, M.:  Periarteritis Nodosa in an Infant of Three Months , Acta Paediat 43:374-378 ( (July) ) 1954;.
Johansmann, R.J., and Zeek, P.:  Periarteritis Nodosa in a Week Old Infant , Arch Path 58:207-213 ( (Sept) ) 1954;.
Rose, G.A.:  The Natural History of Periarteritis , Brit Med J 2:1148-1152 ( (Nov) ) 1957;.
Munro-Faure, H.:  Necrotizing Arteritis of the Coronary Vessels in Infancy , Pediatrics 23:914-926 ( (May) ) 1959;.
Savage, T.R., and Smith, J.F.:  Polyarteritis Nodosa and Congenital Pyloric Hypertrophy in a 3-Month-Old Infant , J Clin Path 13:291-296 ( (July) ) 1960;.
Henry, M.J.; Stoeckle, H.G.E.; and Hopps, H.C.:  Periarteritis in a 4-Month-Old Infant Unresponsive to Penicillinase , Amer Heart J 60:817-822 ( (Nov) ) 1960;.
Roberts, F.B., and Fetterman, G.H.:  Polyarteritis Nodosa in Infancy , J Pediat 63:519-529 ( (Oct) ) 1963;.
Coppoletta, J.A., and Wolback, S.B.:  Body Length and Organ Weights of Infants and Children , Amer J Path 9:55-70 ( (Jan) ) 1933;.
Kambolis, K.P.; Lebhar, N.F.; and Barnett, R.N.:  Coronary Thrombosis and Myocardial Infarction in a 4½-Year-Old Boy , Pediatrics 22:135-144 ( (July) ) 1958;.
Knowles, H.C.; Zeek, P.M.; and Blankenhorn, M.A.:  Studies on Necrotizing Angiitis: IV. Periarteritis Nodosa and Hypersensitivity Angiitis , Arch Intern Med 92:789-805 ( (Dec) ) 1953;.
Zeek, P.M.; Smith, C.C.; and Weeter, J.C.:  Studies on Periarteritis Nodosa: III. The Differentiation Between the Vascular Lesions of Periarteritis Nodosa and of Hypersensitivity , Amer J Path 24:889-917 ( (July) ) 1948;.
Faber, H.K., and Rather, L.J.:  Sudden Death Due to Coronary Insufficiency Resulting From Healed Polyarteritis Nodosa in a Boy of Seven Years , Stanford Med Bull 18:10-20 ( (Feb) ) 1960;.
Diaz-Rivera, R.S., and Miller, A.J.:  Periarteritis Nodosa: A Clinical Pathological Analysis of Seven Cases , Ann Intern Med 24:420-443 ( (March) ) 1946;.
Rich, A.R., and Gregory, J.E.:  The Experimental Demonstration That Periarteritis Nodosa is a Manifestation of Hypersensitivity , Bull Hopkins Hosp 72:65-88, 1943;.
Zeek, P.M.:  Periarteritis Nodosa and Other Forms of Necrotizing Angiitis , New Eng J Med 248: 764-772 ( (April) ) 1953;.

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