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A 65-year old man visited hospital for evaluation of the mass lesion in the right testis. He was also presented with anemia and azotemia. We got the biopsy sample of the right testis by orchiectomy and it revealed a necrotizing vasculitides of medium-sized arteries consistent with the classic polyarteritis nodosa. Kidney biopsy shows a focal proliferative glomerulonephritis without immune deposits on the IF. Serologic study shows a rise of p-ANCA titer definitely. Immediately, we start a therapy of corticosteroids and cyclophosphamide with the diagnosis of atypical PAN. In the course of tapering the dose of cyclophosphamide in OPD, he developed a severe hemoptysis with dyspnea. Because of massive pulmonary hemorrhage, plasmapheresis and mechanical ventilation was done. But the patient got worse in spite of intensive care and finally goes to his death. We report a case of polyangiitis overlap syndrome initially manifested as testicular mass which revealed testicular PAN and developed severe pulmonary hemorrhage in the late course of disease.(Korean J Med 70:S272-S277, 2006)
Key Words : Polyarteritis nodosa, Testis, Pulmonary hemorrhage, Overlap syndrome |
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