Polyarteritis nodosa .
Polyarteritis nodosa is Inflammation of blood vessels. Affecting medium sized arteries.
It can affect almost any part of the body, that’s why it is called poly arteritis.
lung involvement is very rare.
But, kidney is commonly involved. renal artery involvement can be fatal.
Heart and gastrointestinal tract is also commonly affected. Also muscles.

Polyarteritis nodosa is rare but fatal disease.
Without treatment five year survival is only 13 %. With treatment 80 %.

Polyarteritis nodosa is associated with Hepatitis B and hepatitis c. and more common among young males.


Symptoms are different, regarding what part of the body is affected.
But nonspecific common symptoms are:
Low grade fever, fatigue, malaise, weakness, loss of appetite, and unintentional weight loss.

If kidney artery is inflamed and it commonly happens.
Symptoms are:
Hematuria – blood in the urine,
Proteinuria – proteins in the urine.
And hypertension.
Almost all patients with renal polyarteritis nodosa, have renal insufficiency caused by renal artery narrowing, thrombosis, and infarctions.

If skin arteries are inflamed symptoms include:
Rashes, swelling, necrotic ulcers, and subcutaneous nodules (lumps).
Palpable purpura and livedo reticularis in some individuals.
If Gastrointestinal system arteries are involved, then Gastrointestinal bleeding can develop.
Complication
Inflammation of arteries causes thrombosis and tissue death, infarction.
Sometimes inflammation causes small aneurisms.
Those micro aneurysms can rupture and cause bleeding.
Small aneurysms are strung like the beads of a rosary, therefore making "rosary sign" a diagnostic feature of the vasculitis.




Polyarteritis nodosa is difficult to diagnose because characterized variety of symptoms depends on localization of inflamed arteries..
Also no specific blood tests exist for diagnosis.
30 % of cases of polyarteritis nodosa is associated with hepatitis B virus.
Sometimes Perinuclear pattern of antineutrophil cytoplasmic antibodies (pANCA) is elevated.
But it is not classical form of polyarteritis nodosa. It is called microscopic form of polyarteritis. Because it affects small sized arteries. It is called also microscopic polyangiitis.
• Elevated Creactive protein
• ESR (elevated)

Tissue biopsy used to make diagnose. Where you can see inflammation and necrosis.

Treatment.
Treatment involves medications to suppress the immune system, including prednisone and cyclophosphamide.



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By Nantsupawat T et al Nantsupawat, Teerapat (20130101). "Obscure Severe Infrarenal Aortoiliac Stenosis With Severe Transient Lactic Acidosis". Journal of Investigative Medicine High Impact Case Reports 1 (1). DOI:10.1177/2324709613479940. PMID 26425569. PMC: 4528787.</ref>, CC BYSA 3.0, https://commons.wikimedia.org/w/index...