Polyarteritis nodosa

Disease class: Systemic vasculitis

Also known as PAN.

This is mainly a medium-sized vessel vaculitis. It can also affect smaller vessels.

Signs and symptoms

Like the other vasculitides, patients may present with a wide range of features.

In adults, this includes:

• Paresthesia (tingling)
• Anaesthesia (numbness) 
• Weakness (asthenia)
• Skin rashes
• Skin ulcers
• Nodules
• Muscle aches
• Weight loss
• Joint pains
• Fevers
• Abdominal pain (often worse after eating)
• Hypertension 

In children, skin symptoms are more likely to be the first manifestation. 

Complications

• Neuropathy (Nerve damage)
• Dermopathy (Skin damage)
• Arthropathy (Joint damage)
• Enteropathy (Gastrointestinal damage)
• Nephropathy (Kidney damage)

Epidemiology

• Peak incidence in middle age

 

Investigations

• Inflammatory markers
• Anti-Neutrophil Cytoplasmic Antibody is always negative. A positive ANCA result suggests a different vasculitis.
• Tissue biopsy

 

Management

• High dose corticosteroids
• Cyclophosphamide