Polyarteritis nodosa - Revision history

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2025-04-12T12:44:47Z

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← Older revision		Revision as of 12:44, 12 April 2025
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	== Polyarteritis nodosa ==		== Polyarteritis nodosa ==
	Alternate names - PAN; Periarteritis; Polyarteritis		Alternate names - PAN; Periarteritis; Polyarteritis
	~~== '''Definition''' ==~~
	Polyarteritis nodosa (PAN) is a blood vessel disease characterized by [[inflammation]] of small and medium-sized [[arteries]] ([[vasculitis]]), preventing them from bringing oxygen and food to organs.		Polyarteritis nodosa (PAN) is a blood vessel disease characterized by [[inflammation]] of small and medium-sized [[arteries]] ([[vasculitis]]), preventing them from bringing oxygen and food to organs.
	<youtube>		<youtube>
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	* Without treatment, the outlook is poor.		* Without treatment, the outlook is poor.
	{{Systemic vasculitis}}		{{Systemic vasculitis}}
	{{~~Authority control~~}}		{{nt}}
	{{DEFAULTSORT:Polyarteritis Nodosa}}		{{DEFAULTSORT:Polyarteritis Nodosa}}
	[[Category:Disorders of fascia]]		[[Category:Disorders of fascia]]

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2025-04-08T15:33:01Z

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← Older revision		Revision as of 15:33, 8 April 2025
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			{{SI}}
			{{Infobox medical condition
			\| name = Polyarteritis nodosa
			\| image = [[File:Kussmaul_Maier_Makro.jpg\|250px]]
			\| caption = Micrograph of polyarteritis nodosa showing fibrinoid necrosis and inflammation of a small artery
			\| field = [[Rheumatology]]
			\| synonyms = PAN
			\| symptoms = [[Fever]], [[fatigue]], [[weight loss]], [[muscle pain]], [[joint pain]], [[abdominal pain]], [[hypertension]], [[kidney failure]]
			\| complications = [[Aneurysm]], [[stroke]], [[heart attack]], [[renal failure]]
			\| onset = Typically in [[middle age]]
			\| duration = Chronic
			\| causes = Unknown, possibly [[autoimmune]]
			\| risks = [[Hepatitis B]] infection, [[Hepatitis C]] infection
			\| diagnosis = [[Biopsy]], [[angiography]]
			\| differential = [[Microscopic polyangiitis]], [[granulomatosis with polyangiitis]], [[eosinophilic granulomatosis with polyangiitis]]
			\| treatment = [[Corticosteroids]], [[immunosuppressive drugs]]
			\| prognosis = Variable, depends on severity and response to treatment
			\| frequency = Rare
			}}
	== Polyarteritis nodosa ==		== Polyarteritis nodosa ==

	Alternate names - PAN; Periarteritis; Polyarteritis		Alternate names - PAN; Periarteritis; Polyarteritis

	== '''Definition''' ==		== '''Definition''' ==

	~~[[File:Kussmaul Maier Makro.jpg\|thumb]]~~

	Polyarteritis nodosa (PAN) is a blood vessel disease characterized by [[inflammation]] of small and medium-sized [[arteries]] ([[vasculitis]]), preventing them from bringing oxygen and food to organs.		Polyarteritis nodosa (PAN) is a blood vessel disease characterized by [[inflammation]] of small and medium-sized [[arteries]] ([[vasculitis]]), preventing them from bringing oxygen and food to organs.

	<youtube>		<youtube>
	title='''{{PAGENAME}}'''		title='''{{PAGENAME}}'''
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	height=600		height=600
	</youtube>		</youtube>

	== '''Cause''' ==		== '''Cause''' ==
	* The exact cause of polyarteritis nodosa (PAN) is not known, and in most cases, no predisposing cause has been found (it is [[idiopathic]]).		* The exact cause of polyarteritis nodosa (PAN) is not known, and in most cases, no predisposing cause has been found (it is [[idiopathic]]).
	* Many scientists believe that it is an [[autoimmune disease]].		* Many scientists believe that it is an [[autoimmune disease]].
	* Research has suggested that an '''abnormal immune response to an initial infection may trigger the development of PAN'''.		* Research has suggested that an '''abnormal immune response to an initial infection may trigger the development of PAN'''.
	* However, the reasons that many smaller arteries and capillaries are spared is not understood.		* However, the reasons that many smaller arteries and capillaries are spared is not understood.
	* [[Hepatitis B virus]] (HBV), [[hepatitis C]], and [[hairy cell leukemia]] have been associated with some cases of PAN.		* [[Hepatitis B virus]] (HBV), [[hepatitis C]], and [[hairy cell leukemia]] have been associated with some cases of PAN.
	* In one report from France, HBV accounted for a third of the cases of PAN.		* In one report from France, HBV accounted for a third of the cases of PAN.
	* HBV-related PAN typically occurs within four months after the onset of HBV infection.		* HBV-related PAN typically occurs within four months after the onset of HBV infection.
	* PAN has also been '''seen in drug abusers''' (particularly those using [[amphetamines]]).		* PAN has also been '''seen in drug abusers''' (particularly those using [[amphetamines]]).
	* It has also appeared to occur as an''' allergic reaction to some drugs and vaccines'''.		* It has also appeared to occur as an''' allergic reaction to some drugs and vaccines'''.
	* The specific symptoms of PAN are due to [[ischemia]] or infarction of tissues and organs.		* The specific symptoms of PAN are due to [[ischemia]] or infarction of tissues and organs.
	* Thickening of the walls of affected vessels causes narrowing of the inside of the vessels, reducing blood flow and predisposing to blood clots in affected vessels.		* Thickening of the walls of affected vessels causes narrowing of the inside of the vessels, reducing blood flow and predisposing to blood clots in affected vessels.

	== '''Signs and symptoms''' ==		== '''Signs and symptoms''' ==
	Symptoms are caused by damage to affected organs. The skin, joints, muscle, gastrointestinal tract, heart, kidneys, and nervous system are often affected.		Symptoms are caused by damage to affected organs. The skin, joints, muscle, gastrointestinal tract, heart, kidneys, and nervous system are often affected.

	Symptoms include:		Symptoms include:
	* Abdominal pain		* Abdominal pain
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	* Weakness		* Weakness
	* If nerves are affected, you may have numbness, pain, burning, and weakness. Damage to the nervous system may cause [[strokes]] or [[seizures]].		* If nerves are affected, you may have numbness, pain, burning, and weakness. Damage to the nervous system may cause [[strokes]] or [[seizures]].

	== '''Clinical presentation''' ==		== '''Clinical presentation''' ==
	For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed.		For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed.

	'''30%-79% of people have these symptoms'''		'''30%-79% of people have these symptoms'''
	* Abnormality of the kidney(Abnormal kidney)		* Abnormality of the kidney(Abnormal kidney)
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	* [[Polyneuritis]]		* [[Polyneuritis]]
	* Weight loss		* Weight loss

	'''5%-29% of people have these symptoms'''		'''5%-29% of people have these symptoms'''
	* Abdominal pain(Pain in stomach)		* Abdominal pain(Pain in stomach)
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	* Skin ulcer(Open skin sore)		* Skin ulcer(Open skin sore)
	* Subcutaneous nodule(Firm lump under the skin)		* Subcutaneous nodule(Firm lump under the skin)

	'''1%-4% of people have these symptoms'''		'''1%-4% of people have these symptoms'''
	* Abnormality of the eye(Abnormal eye)		* Abnormality of the eye(Abnormal eye)
	* [[Cardiomyopathy]](Disease of the heart muscle)		* [[Cardiomyopathy]](Disease of the heart muscle)
	* [[Pleuritis]](Inflammation of tissues lining lungs and chest)		* [[Pleuritis]](Inflammation of tissues lining lungs and chest)

	== '''Diagnosis''' ==		== '''Diagnosis''' ==
	No specific lab tests are available to diagnose polyarteritis nodosa.		No specific lab tests are available to diagnose polyarteritis nodosa.
	There are a number of disorders that have features similar to polyarthritis nodosa. These are known as "mimics."		There are a number of disorders that have features similar to polyarthritis nodosa. These are known as "mimics."

	You will have a complete physical exam.		You will have a complete physical exam.

	Lab tests that can help make the diagnosis and rule out mimics include:		Lab tests that can help make the diagnosis and rule out mimics include:
	* [[Complete blood count (CBC)\|Complete blood count]] (CBC) with differential, [[creatinine]], tests for [[hepatitis B]] and C, and [[urinalysis]]		* [[Complete blood count (CBC)\|Complete blood count]] (CBC) with differential, [[creatinine]], tests for [[hepatitis B]] and C, and [[urinalysis]]
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	* Anti-phospholipid antibodies		* Anti-phospholipid antibodies
	* [[Blood culture\|Blood cultures]]		* [[Blood culture\|Blood cultures]]

	== '''Treatment''' ==		== '''Treatment''' ==
	* There is no cure for polyarteritis nodosa (PAN), but the disease and its symptoms can be managed.		* There is no cure for polyarteritis nodosa (PAN), but the disease and its symptoms can be managed.
	* The goal of treatment is to prevent disease progression and further organ damage.		* The goal of treatment is to prevent disease progression and further organ damage.
	* The exact treatment depends on the severity in each person.		* The exact treatment depends on the severity in each person.
	* While many people do well with treatment, relapses can occur.		* While many people do well with treatment, relapses can occur.
	* When the cause of PAN is unknown ([[idiopathic]]), treatment involves [[corticosteroids]] and [[Immunosuppressive Drugs\|immunosuppressive medications]].		* When the cause of PAN is unknown ([[idiopathic]]), treatment involves [[corticosteroids]] and [[Immunosuppressive Drugs\|immunosuppressive medications]].
	* If there are no serious neurologic, renal, gastrointestinal, or heart symptoms, corticosteroids may initially be sufficient.		* If there are no serious neurologic, renal, gastrointestinal, or heart symptoms, corticosteroids may initially be sufficient.
	* For severe disease with these symptoms, [[cyclophosphamide]] may also be used.		* For severe disease with these symptoms, [[cyclophosphamide]] may also be used.
	* [[Hypertension]] should be treated aggressively.		* [[Hypertension]] should be treated aggressively.
	* When PAN is related to [[hepatitis B]], treatment often involves [[steroids]], anti-viral medications and sometimes [[plasma exchange]] (also called plasmapheresis).		* When PAN is related to [[hepatitis B]], treatment often involves [[steroids]], anti-viral medications and sometimes [[plasma exchange]] (also called plasmapheresis).

	== '''Prognosis''' ==		== '''Prognosis''' ==
	* Current treatments with steroids and other drugs that suppress the immune system (such as [[azathioprine]] or [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival.		* Current treatments with steroids and other drugs that suppress the immune system (such as [[azathioprine]] or [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival.
	* The most serious complications most often involve the kidneys and gastrointestinal tract.		* The most serious complications most often involve the kidneys and gastrointestinal tract.
	* Without treatment, the outlook is poor.		* Without treatment, the outlook is poor.

	{{Systemic vasculitis}}		{{Systemic vasculitis}}

	{{Authority control}}		{{Authority control}}

	{{DEFAULTSORT:Polyarteritis Nodosa}}		{{DEFAULTSORT:Polyarteritis Nodosa}}
	[[Category:Disorders of fascia]]		[[Category:Disorders of fascia]]

Kondreddy Naveen at 22:47, 18 January 2024

2024-01-18T22:47:50Z

New page

== Polyarteritis nodosa ==

Alternate names - PAN; Periarteritis; Polyarteritis

== '''Definition''' ==

[[File:Kussmaul Maier Makro.jpg|thumb]]

Polyarteritis nodosa (PAN) is a blood vessel disease characterized by [[inflammation]] of small and medium-sized [[arteries]] ([[vasculitis]]), preventing them from bringing oxygen and food to organs.

<youtube>
title='''{{PAGENAME}}'''
movie_url=http://www.youtube.com/v/=MdsKkpgRyXc
&rel=1
embed_source_url=http://www.youtube.com/v/=MdsKkpgRyXc
&rel=1
wrap = yes
width=750
height=600
</youtube>

== '''Cause''' ==
* The exact cause of polyarteritis nodosa (PAN) is not known, and in most cases, no predisposing cause has been found (it is [[idiopathic]]).
* Many scientists believe that it is an [[autoimmune disease]].
* Research has suggested that an '''abnormal immune response to an initial infection may trigger the development of PAN'''.
* However, the reasons that many smaller arteries and capillaries are spared is not understood.
* [[Hepatitis B virus]] (HBV), [[hepatitis C]], and [[hairy cell leukemia]] have been associated with some cases of PAN.
* In one report from France, HBV accounted for a third of the cases of PAN.
* HBV-related PAN typically occurs within four months after the onset of HBV infection.
* PAN has also been '''seen in drug abusers''' (particularly those using [[amphetamines]]).
* It has also appeared to occur as an''' allergic reaction to some drugs and vaccines'''.
* The specific symptoms of PAN are due to [[ischemia]] or infarction of tissues and organs.
* Thickening of the walls of affected vessels causes narrowing of the inside of the vessels, reducing blood flow and predisposing to blood clots in affected vessels.

== '''Signs and symptoms''' ==
Symptoms are caused by damage to affected organs. The skin, joints, muscle, gastrointestinal tract, heart, kidneys, and nervous system are often affected.

Symptoms include:
* Abdominal pain
* Decreased appetite
* Fatigue
* Fever
* Joint aches
* Muscle aches
* Unintentional weight loss
* Weakness
* If nerves are affected, you may have numbness, pain, burning, and weakness. Damage to the nervous system may cause [[strokes]] or [[seizures]].

== '''Clinical presentation''' ==
For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed.

'''30%-79% of people have these symptoms'''
* Abnormality of the kidney(Abnormal kidney)
* [[Arthralgia]](Joint pain)
* Elevated [[C-reactive protein]] level
* Fever
* [[Myalgia]](Muscle ache)
* [[Polyneuritis]]
* Weight loss

'''5%-29% of people have these symptoms'''
* Abdominal pain(Pain in stomach)
* Abnormality of the gastrointestinal tract
* [[Cutis marmorata]]
* [[Erythema]]
* [[Hypertension]]
* Morphological central nervous system abnormality
* [[Pericarditis]](Swelling or irritation of membrane around heart)
* Raynaud phenomenon
* Sensory axonal neuropathy
* Skin ulcer(Open skin sore)
* Subcutaneous nodule(Firm lump under the skin)

'''1%-4% of people have these symptoms'''
* Abnormality of the eye(Abnormal eye)
* [[Cardiomyopathy]](Disease of the heart muscle)
* [[Pleuritis]](Inflammation of tissues lining lungs and chest)

== '''Diagnosis''' ==
No specific lab tests are available to diagnose polyarteritis nodosa.
There are a number of disorders that have features similar to polyarthritis nodosa. These are known as "mimics."

You will have a complete physical exam.

Lab tests that can help make the diagnosis and rule out mimics include:
* [[Complete blood count (CBC)|Complete blood count]] (CBC) with differential, [[creatinine]], tests for [[hepatitis B]] and C, and [[urinalysis]]
* [[Erythrocyte sedimentation rate]] (ESR) or [[C-reactive protein]] (CRP)
* Serum protein electrophoresis, [[cryoglobulins]]
* Serum complement levels
* [[Arteriogram]]
* Tissue [[biopsy]]
* Other blood tests will be done to rule out similar conditions, such as [[systemic lupus erythematosus]] (ANA) or [[granulomatosis with polyangiitis]] (ANCA)
* Test for [[HIV]]
* [[Cryoglobulins]]
* Anti-phospholipid antibodies
* [[Blood culture|Blood cultures]]

== '''Treatment''' ==
* There is no cure for polyarteritis nodosa (PAN), but the disease and its symptoms can be managed.
* The goal of treatment is to prevent disease progression and further organ damage.
* The exact treatment depends on the severity in each person.
* While many people do well with treatment, relapses can occur.
* When the cause of PAN is unknown ([[idiopathic]]), treatment involves [[corticosteroids]] and [[Immunosuppressive Drugs|immunosuppressive medications]].
* If there are no serious neurologic, renal, gastrointestinal, or heart symptoms, corticosteroids may initially be sufficient.
* For severe disease with these symptoms, [[cyclophosphamide]] may also be used.
* [[Hypertension]] should be treated aggressively.
* When PAN is related to [[hepatitis B]], treatment often involves [[steroids]], anti-viral medications and sometimes [[plasma exchange]] (also called plasmapheresis).

== '''Prognosis''' ==
* Current treatments with steroids and other drugs that suppress the immune system (such as [[azathioprine]] or [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival.
* The most serious complications most often involve the kidneys and gastrointestinal tract.
* Without treatment, the outlook is poor.

{{Systemic vasculitis}}

{{Authority control}}

{{DEFAULTSORT:Polyarteritis Nodosa}}
[[Category:Disorders of fascia]]
[[Category:Rheumatology]]
[[Category:Steroid-responsive inflammatory conditions]]
[[Category:Systemic connective tissue disorders]]
[[Category:Vascular-related cutaneous conditions]]
[[Category:Hepatitis C virus-associated diseases]]
{{rarediseases}}
{{stub}}