Unilateral facial swelling and exophthalmos in a patient with polyarteritis nodosa.

A patient with polyarteritis nodosa (PN) presenting with exophthalmos and facial swelling, which are rarely found in PN, is reported. The patient, a 27-year-old male, complained of painful facial swelling and diplopia. Physical examinations showed facial swelling around the right orbit and exophthalmos. After admission, he experienced myalgia in both calves. Laboratory studies disclosed leukocytosis and liver dysfunction. Celiac and renal angiograms showed aneurysms. A biopsy specimen of his left calf showed an arterial inflammatory process. The patient was diagnosed as having PN. He had an excellent response to corticosteroids, with prompt improvement.