Patient male, 41 years old. Due to repeated lymphadenopathy 8 years, upper limb pain 1 year, increased 2 weeks admission.The patient had no induction of neck, axillary and elbows under the elbow, no lower limb paralysis, pain, and obvious changes in the weather. (30 mg, l times / d) + cyclophosphamide (1 g, 1 & lt; RTI ID = 0.0 & gt; 1) & lt; / RTI & gt; (75 mg, 2 times / d) and aspirin (100 mg, once / d), followed by self-medication, in the local hospital for traditional Chinese medicine treatment, both lower limb paralysis and pain Sexual aggravated, and the emergence of both lower extremity gangrene, in 2005 the right lower limb amputation. In 2006, the left lower limb gangrene increased, check blood routine: neutrophils 8.61 × 109 / L, neutrophil ratio 0.642, platelet 172 × 109 / L, Hb 144 g / L, white blood cells 13.41 × 109 / L; Acid granulocytes 1.48 × 109 / L [reference value (0.02 ~ 0.50) × 109 / L], eosinophil ratio 0.11 (reference value of 0.01 ~ 0.05), the same year in June left limb amputation. 1 year ago, patients began to appear after the activities of upper limb pain, numbness, traction, holding items when the upper limb swelling, pain, inconvenience, local hospital examination upper limb vascular ultrasound prompted bilateral axillary artery, brachial artery and ulnar artery blood Flow signal intermittent, thrombosis and partial recanalization, consider the nodular polyarteritis, to improve the cycle (specific treatment is unknown), anti-inflammatory (specific treatment is not familiar) and other symptomatic treatment, double upper limb pain improved significantly. 2 weeks, patients with double upper limb pain symptoms further increased, for further treatment in July 30, 2010 into our hospital. Past history: 2003 due to precordial muzzle pain diagnosed as coronary heart disease, coronary artery stent placement. No history of diabetes, history of diabetes, no hepatitis, tuberculosis, history of typhoid fever, no food, history of drug allergy. Personal history, marriage and marriage history, family history, no special. In this case the diagnosis and treatment process tips: (1) when the common disease is not enough to explain the general condition of the disease, do not confine to the common disease, the exception has been diagnosed as nodular polyarteritis, but the evidence is not sufficient, the clinician should be active Looking for evidence or keep track of observation.(2) for many diseases, pathological diagnosis is often the gold standard, clinicians should cooperate with the pathologist in a timely manner, to improve the diagnosis of disease greatly help.