PMC6476074_01
Fibrinoid necrosis of the wall of interfascicular medium vessels with infiltration of inflammatory cells in muscle biopsy: (a) 10 x 10 and (b) 40 x 10.
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fig1
Calf muscle biopsy was performed, and histology showed fibrinoid necrosis of the wall of interfascicular small and medium vessels with infiltration of inflammatory cells (Figure 1).
Vasculitic rash over the legs (a), which later developed into the ecchymotic stage (b).
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On the day 14 after admission, a vasculitic-type generalized rash appeared over the extensor surfaces of the forearms and legs (Figure 2(a)). Despite high-dose steroids with pulse therapy over one week, the rash progressed to an ecchymotic stage (Figure 2(b)).
Bilateral foot drop (a) and left ulnar claw (b).
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Subsequently, we noticed that he developed bilateral foot drop, and after few days, he developed left ulnar claw (Figures 3(a) and 3(b)).
Stenosed segment of the celiac artery in CT angiogram (arrows).
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Hence, we performed a renal and mesenteric artery CT angiogram which revealed 8 mm stenosed segment of celiac artery 5 cm distal to its origin without evidence of visible aneurysms elsewhere (Figure 4).