Spontaneous bilateral renal aneurysm rupture secondary to Polyarteritis Nodosa in a patient with chronic myelomonocytic leukaemia: A case report study

• Polyarteritis Nodosa (PAN) can be associated with chronic myelomonocytic leukaemia (CMML).
• Spontaneous bilateral renal haemorrhage as the initial manifestation of PAN in association with CMML is a rare condition.
• Early diagnosis and treatment is vital for patient’s survival.
• Normal renal function can be regained with early artery embolization, steroids and cyclophosphamide treatment.

IntroductionPolyarteritis Nodosa (PAN) is a systemic vasculitis affecting small and medium size arteries resulting in microaneurysms formation. Bilateral renal aneurysm rupture is a rare and life threatening complication. Although uncommon, PAN has been associated with chronic myelomonocytic leukaemia (CMML).Presentation of caseWe report a case of a 77-year-old female with a known CMML, presented to hospital with abdominal pain. Left initially and right renal microaneurym ruptures were shown in CT scan within one-week interval. Microaneurysms were treated with embolization with microcoils. A diagnosis of PAN was made and treated with successful outcome with steroids, cyclophosphamide.ConclusionSpontaneous bilateral renal haemorrhage as the initial manifestation of PAN in association with CMML is a rare condition and it can be associated in delays in diagnosis and treatment. Clinicians should be aware of this possible complication in their daily clinical practice.