Table 2: Literature review of polyarteritis nodosa and tongue necrosis in pediatrics.
Ref | Age/Sex | Features | Laboratory Studies | Pathology | Angiography | Treatment |
Current Case | 6 yr/F | Fever, arthralgias, ulcers, skin nodules, tongue necrosis | Leukocytosis, elevated ESR/CRP, + ASO and anti-DNase B titers | Fibrinoid necrosis and necrotizing vasculitis | Abnormal renal artery | High IV steroids followed by pulse cyclophosphamide and tapered steroids; ACE inhibitor |
3 | 11 yr/F | Fever, tongue pain, pain with mastication | Elevated ESR and CRP; ASO titer: 1,603 U/ml | Fibrinoid necrosis [3] | Unremarkable | IV steroids 30 mg/kg, pulse cyclophosphamide |
30 | 7 yr/M | Fatigue, fever, oral blisters, painful tongue, arthralgias | Leukocytosis, elevated ESR and CRP; antiDNAse titer 3200 U/ml | Tongue biopsy: fibrinoid vessel necrosis, eosinophilia [6] | NR | Prednisolone 2 mg/kg with slow taper after 4 months [6] |
REFP: Reference, M: Male, F: Female, ESR: Erythrocyte Sedimentation Rate, CRP: C-Reactive Protein, ASO: Antistreptolysin O Antibodies, NR: Not Reported.