{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T09:53:22Z","timestamp":1791280402701,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":278,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Rheumatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cutaneous polyarteritis nodosa (cPAN) is a rare necrotizing vasculitis affecting medium\u2010sized skin vessels and may be refractory to standard immunosuppressive therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report a 23\u2010year\u2010old male with HLA\u2010B27\u2013positive enthesitis\u2010associated arthritis (ERA), which was reclassified during the disease course and is currently in clinical remission under interleukin\u201017 inhibition, and reading epilepsy, presenting with histologically confirmed cPAN. Despite multiple treatments, including methotrexate, corticosteroid pulses, tumor necrosis factor\u2010\u03b1 (TNF\u2010\u03b1) inhibitors, and tocilizumab, the patient developed persistent painful livedo reticularis\u2010like lesions with palpable subcutaneous nodules and systemic symptoms. Intravenous immunoglobulin (IVIG) was initiated at 1.5\u2009g\/kg per cycle (administered over three consecutive days; total dose \u223c100\u2009g per cycle) and repeated every eight weeks, followed by a clinically meaningful response after the first cycle and complete resolution of symptoms within one month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The addition of IVIG may represent an effective escalation option for refractory cPAN. Further studies are needed to clarify its role in this rare vasculitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crrh\/4646918","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T09:16:26Z","timestamp":1791278186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Addition of Intravenous Immunoglobulin in Refractory Cutaneous Polyarteritis Nodosa: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1586-324X","authenticated-orcid":false,"given":"Fabio","family":"Kohlmann","sequence":"first","affiliation":[{"name":"School of Medicine, Faculty of Health Witten\/Herdecke University  Witten Germany  uni-wh.de"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Odehnal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology Rheumazentrum Ruhrgebiet Marien Hospital Herne University Hospital of Ruhr University Bochum  Herne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Buchtala","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Prof. Hess Children\u2019s Center Klinikum Bremen-Mitte  Bremen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7742-7526","authenticated-orcid":false,"given":"Anna","family":"Kernder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology Rheumazentrum Ruhrgebiet Marien Hospital Herne University Hospital of Ruhr University Bochum  Herne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology Rheumazentrum Ruhrgebiet Marien Hospital Herne University Hospital of Ruhr University Bochum  Herne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key322"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2021.102784"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2023.45.92.36496"},{"key":"e_1_2_12_5_2","first-page":"73","article-title":"[Cutaneous Polyarteritis Nodosa]","volume":"71","author":"Turska M.","year":"2018","journal-title":"Wiadomosci Lekarskie"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.116657"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215048"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.23081"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2023.102995"},{"key":"e_1_2_12_10_2","volume-title":"P\u00e4diatrische Rheumatologie. Springer Reference Medizin","author":"Benseler S.","year":"2022"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/135245850000602s07"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15868"}],"container-title":["Case Reports in Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crrh\/4646918","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crrh\/4646918","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crrh\/4646918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T09:16:27Z","timestamp":1791278187000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crrh\/4646918"}},"subtitle":[],"editor":[{"given":"Ankit","family":"Dhoundiyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crrh\/4646918"],"URL":"https:\/\/doi.org\/10.1155\/crrh\/4646918","archive":["Portico"],"relation":{},"ISSN":["2090-6889","2090-6897"],"issn-type":[{"value":"2090-6889","type":"print"},{"value":"2090-6897","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4646918"}}