Mycophenolate mofetil treatment in two children with severe polyarteritis nodosa refractory to immunosuppressant drugs

Polyarteritis nodosa (PAN) is a necrotizing vasculitis of small- and medium-sized arteries with multiorgan involvement, rarely reported in childhood. Despite aggressive treatment with the combination of corticosteroids and cytotoxic agents, the overall prognosis is poor in most patients. We report on two siblings, now 15- and 14-yearold, aVected with childhood onset PAN, refractory to multiple therapies, who showed rapid clinical and laboratory improvement when mycophenolate mofetil was introduced. The relationship between the administration of this immunosuppressant agent and the reduced disease activity is conWrmed by the sustained absence of disease Xares over 4 years of treatment. © Springer-Verlag 2011.