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Polyarteritis Nodosa
Aka: Polyarteritis Nodosa
- See Also
- Vasculitis
- Epidemiology
- Prevalence: May approach 33 Million cases worldwide
- Gender: Slight male predominance
- Age: 30-40 years old
- Classification
- ANCA negative Vasculitis
- Now differentiated from microscopic polyangitis
- Pathophysiology
- Medium vessel Vasculitis involving muscular arteries
- Can affect any organ (esp. Kidney, skin, joint, muscle, nerve, Intestine), but typically does not involve the lung
- Effects are related to vessel wall thickening, vessel narrowing and ultimately arterial Occlusion with secondary tissue infarction
- Associated Conditions
- Hepatitis B Infection
- Hepatitis C Infection
- Hairy Cell Leukemia
- Symptoms
- Fever
- Weight loss
- Hypertension
- Abdominal Pain
- Melena
- Peripheral neuritis
- Signs: Skin
- Tender erythematous Nodules similar to Erythema Nodosum
- Palpable Purpura
- Livedo reticularis
- Skin Ulceration
- Vesicobullous lesions
- Signs: Systemic
- Renal Insufficiency
- Hypertension
- Mononeuropathy Multiplex
- Neuropathy
- Myopathy
- Mesenteric arteritis
- Coronary ischemia
- Labs
- Vasculitis labs (evaluate differential diagnosis)
- ANCA negative
- Serum Creatinine
- Creatinine Phosphokinase (CPK)
- Liver Function Tests
- Hepatitis B Surface Antigen
- Anti-Hepatitis C Antibody
- Urinalysis
- C-Reactive Protein (negative result would suggest alternative diagnosis)
- Imaging
- Chest XRay (evaluate differential diagnosis)
- Diagnosis
- Tissue Biopsy
- Imaging (CT Angiogram, MR Angiogram)
- Differential Diagnosis
- See Vasculitis
- Infection
- Endocarditis
- Mycotic aneurysm
- Hepatitis B Infection
- Hepatitis C Infection
- HIV Infection
- Non-infectious causes
- Atypical thromboembolic conditions (e.g. atrial myoma, antiphospholipid Antibody syndrome)
- Fibromuscular dysplasia
- Management
- Corticosteroids
- References
- Merkel (2011) in UpToDate, Clinical features and diagnosis of Takayasu Arteritis, Accessed 11/30/11