A 50-year-old drug abuser presents with fever and weight loss. Exam
shows hypertension, nodular skin rash, and peripheral neuropathy. ESR is
100 mm/L, and RBC casts are seen on urinalysis. The most likely
condition is:
A. Reiter syndromeb.
B. Drug-induced lupus erythematosus
C. Polyarteritisnodosa
D. Behçet syndrome
Ans. C. The 50-year-old gentleman is a drug abuser and also has a multisystem disease, including systemic complaints, hypertension, skin lesions, neuropathy, and an abnormal urine sediment. This complex suggests a vasculitis, particularly polyarteritisnodosa. 20 to 30% of patients have hepatitis B antigenemia. The disease is a necrotizing vasculitis of small and medium muscular arteries. The pathology of the kidney includes an arteritis and, in some cases, a glomerulitis. Nodular skin lesions show vasculitis on biopsy.
A. Reiter syndromeb.
B. Drug-induced lupus erythematosus
C. Polyarteritisnodosa
D. Behçet syndrome
Ans. C. The 50-year-old gentleman is a drug abuser and also has a multisystem disease, including systemic complaints, hypertension, skin lesions, neuropathy, and an abnormal urine sediment. This complex suggests a vasculitis, particularly polyarteritisnodosa. 20 to 30% of patients have hepatitis B antigenemia. The disease is a necrotizing vasculitis of small and medium muscular arteries. The pathology of the kidney includes an arteritis and, in some cases, a glomerulitis. Nodular skin lesions show vasculitis on biopsy.
