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Polyarteritis Nodosa | Clinical Features | Complications | Management

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▬▬▬▬▬▬▬▬▬▬ Contents of this video ▬▬▬▬▬▬▬▬▬▬

00:10 Intro
05:00 Definition
08:00 Example
10:00 Complete

Polyarteritis nodosa
Periarteritis nodosa; PAN; Systemic necrotizing vasculitis

Polyarteritis nodosa is a serious inflammatory blood vessel disease. The small and mediumsized arteries become swollen and damaged.

Causes
Arteries are the blood vessels that carry oxygenrich blood to organs and tissues. The cause of polyarteritis nodosa is unknown. The condition occurs when certain immune cells attack the affected arteries. The tissues that are fed by the affected arteries do not get the oxygen and nourishment they need. Damage occurs as a result.

More adults than children get this disease.

People with active hepatitis B or hepatitis C may develop this disease.

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.

Exams and Tests
No specific lab tests are available to diagnose polyarteritis nodosa. There are a number of disorders that have features similar to polyarteritis 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) with differential, creatinine, tests for hepatitis B and C, and urinalysis
Erythrocyte sedimentation rate (ESR) or Creactive 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
Test for hepatitis B and hepatitis C
Cryoglobulins
Antiphospholipid antibodies
Blood cultures
Treatment
Treatment involves medicines to suppress inflammation and the immune system. These may include steroids, such as prednisone. Similar medicines, such as azathioprine, methotrexate or mycophenolate that allow for reducing the dose of steroids are often used as well. Cyclophosphamide is used in severe cases.

For polyarteritis nodosa related to hepatitis, treatment may involve plasmapheresis and antiviral medicines.

Outlook (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 longterm survival.

The most serious complications most often involve the kidneys and gastrointestinal tract.

Without treatment, the outlook is poor.

Possible Complications
Complications may include:

Heart attack
Intestinal necrosis and perforation
Kidney failure
Stroke
When to Contact a Medical Professional
Contact your health care provider if you develop symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome.

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