Polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of small- and medium-sized muscular arteries characterized by its involvement of the renal and visceral arteries. There is a form of PAN that is restricted to skin (cutaneous PAN).
Causes of Polyarteritis Nodosa
Necrotizing inflammation of small- and medium-sized muscular arteries; may spread circumferentially to involve adjacent veins. Lesions segmental, tend to involve bifurcations of arteries. About 30% of cases associated with hepatitis B antigenemia, i.e., immune complex formation.
Symptoms of Polyarteritis Nodosa
In this disease, symptoms result from damage to affected organs, often the skin, heart, kidneys, and nervous system.
Generalised symptoms include fever, fatigue, weakness, loss of appetite, and weight loss. Muscle and joint aches are common. The skin may show rashes, swelling, ulcers, and lumps.
Nerve involvement may cause sensory changes with numbness, pain, burning, and weakness.
Diagnosis
There are no specific lab tests for diagnosing polyarteritis nodosa. Diagnosis is generally based upon the physical examination and a few laboratory studies that help to confirm the diagnosis:
- CBC (may demonstrate an elevated white blood count)
- Tissue biopsy (reveals inflammation in small arteries, called arteritis)
- ESR (often elevated)
- Immunoglobulins (may be increased)
Treatment
Systemic PAN Combined Therapy Prednisone, 1 mg/kg of body weight per day, and cyclophosphamide, 2 mg/kg/d.
Cutaneous PAN Nonsteroidal anti-inflammatory agents, prednisone.
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