PMID- 6114636
OWN - NLM
STAT- MEDLINE
DCOM- 19810925
LR  - 20190627
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 71
IP  - 2
DP  - 1981 Aug
TI  - Trichinosis-related polyarteritis nodosa.
PG  - 307-12
AB  - During an outbreak of trichinosis, two young men--one with established 
      trichinosis and the other with suspected infection--were found to have clinical, 
      radiologic and histologic stigmata of a systemic necrotizing vasculopathy 
      equivalent to classic polyarteritis nodosa. The parasitosis manifested as a 
      pentad of fever, myalgias, facial edema, eosinophilia and hyperimmunoglobulinemia 
      E. Features of the arteritis included mononeuritis multiplex, pain in the abdomen 
      and joints, weight loss, hypertension, leukocytosis, thrombocytosis, 
      microhematuria and raised alkaline phosphatase levels. A sustained remission was 
      achieved by the administration of thiabendazole, prednisone and cyclophosphamide. 
      Pathogenetic links between the two diseases are presented: (1) deposition of 
      circulating immune complexes in the vessel wall; (2) adjuvant activity with cross 
      reaction between parasitic antigen and human vessel wall; (3) immunoglobulin E 
      (IgE) aggregates and soluble antigen IgE complexes precipitation in vessel wall; 
      and (4) hypereosinophilia-induced tissue damage. A causal relationship of 
      trichinosis to polyarteritis nodosa is persuasive, and we suggest that cases of 
      hepatitis B surface antigen (HBsAg) negative polyarteritis nodosa, especially 
      those in which myalgias and eosinophilia are prominent, may be related to 
      trichinosis and that, conversely, patients with trichinosis and multiorgan 
      disease should be studied for polyarteritis nodosa.
FAU - Frayha, R A
AU  - Frayha RA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Antigen-Antibody Complex)
RN  - 0 (Antigens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - N1Q45E87DT (Thiabendazole)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Adult
MH  - Antigen-Antibody Complex/*immunology
MH  - Antigens
MH  - Child
MH  - Cross Reactions
MH  - Cyclophosphamide/therapeutic use
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Male
MH  - Polyarteritis Nodosa/drug therapy/immunology/*parasitology
MH  - Prednisone/therapeutic use
MH  - Thiabendazole/therapeutic use
MH  - Trichinella/immunology
MH  - Trichinellosis/*complications/drug therapy/immunology
EDAT- 1981/08/01 00:00
MHDA- 1981/08/01 00:01
CRDT- 1981/08/01 00:00
PHST- 1981/08/01 00:00 [pubmed]
PHST- 1981/08/01 00:01 [medline]
PHST- 1981/08/01 00:00 [entrez]
AID - 0002-9343(81)90133-9 [pii]
AID - 10.1016/0002-9343(81)90133-9 [doi]
PST - ppublish
SO  - Am J Med. 1981 Aug;71(2):307-12. doi: 10.1016/0002-9343(81)90133-9.