A 38-year-old man with malaise, weight loss, abdominal pain, and hypertension has livedo reticularis. Mesenteric angiography shows multiple small aneurysmal dilatations in branches of the superior mesenteric artery. Serology is positive for hepatitis B surface antigen. Which vasculitis fits this picture?
- A Microscopic polyangiitis
- B Granulomatosis with polyangiitis
- C Classic polyarteritis nodosa ✓
- D Churg-Strauss syndrome
Correct answer: C. Classic polyarteritis nodosa
Explanation
Classic polyarteritis nodosa is a necrotizing transmural inflammation of medium-sized muscular arteries, strongly linked to hepatitis B virus infection. Segmental fibrinoid necrosis weakens the wall and produces the microaneurysms seen on angiography. Renal involvement causes renovascular hypertension. Unlike ANCA-associated vasculitides, PAN is ANCA-negative and does not produce glomerulonephritis or pulmonary capillaritis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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