Succeeding onset of hepatic, splenic, and renal infarction in polyarteritis nodosa.

TO THE EDITOR: Polyarteritis nodosa (PAN) is a systemic vasculitis involving medium-sized vessel, characterized by focal, panmural, necrotizing, and inflammatory lesions with a predilection for the vessel bifurcation (1). Although PAN may affect any organ with vascular and thromboembolic manifestations with consequent tissue ischemia, liver and splenic infarction are rarely described (2, 3). We report the extraordinary case of a 65-yr-old man presenting with severe abdominal pain, in which the sudden onset of contemporary, massive liver, and splenic infarction was the first manifestation of an underlying PAN. Interestingly, after a few days of hospitalization, the patient also developed bilateral renal infarctions.