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Polyarteritis Nodosa

Ratnesh Chopra and Yevgeniy Popov, MPH, D.O Reviewed 06/2021
 


BASICS

DESCRIPTION

  • Polyarteritis nodosa (PAN) is an antineutrophil cytoplasmic antibody (ANCA)-negative necrotizing arteritis of medium-sized muscular arteries and (occasionally) small arteries. Arteri...

DIAGNOSIS

  • There are no formal diagnostic criteria for PAN (1,2).

  • Suspect PAN with:

    • Acute, sometimes fulminant multisystem disease with a relatively short prodrome (i.e., weeks to months)

    • Vasculitic skin...

TREATMENT

GENERAL MEASURES

Treat HTN aggressively to prevent complications (stroke, myocardial infarction, heart failure). 

MEDICATION

First Line

  • Severe (life-threatening) disease: corticosteroids (CS) (h...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • CBC, urinalysis, renal and hepatic function tests.

  • Acute-phase reactants (e.g., ESR, CRP) may help monitor disease activity.

  • The revised 2009 Five...

REFERENCES

1
De Virgilio  A, Grego  A, Magliulo  G, et al. Polyarteritis nodosa: a contemporary overview. Autoimmun Rev.  2016;15(6):564–570. [View Abstract on OvidMedline]...

ADDITIONAL READING

Samson  M, Puéchal  X, Mouthon  L, et al; for French Vasculitis Study Group. Microscopic polyangiitis and non-HBV polyarteritis nodosa with poor-prognosis facto...

SEE ALSO

Hepatitis B; Hepatitis C 

CODES

ICD10

  • M30.0 Polyarteritis nodosa

  • M30.1 Polyarteritis with lung involvement [Churg-Strauss]

  • M30.8 Other conditions related to polyarteritis nodosa

  • M31.7 Microscopic polyangiitis

SNOMED

  • 155441006 Polyar...

CLINICAL PEARLS

  • PAN is a necrotizing vasculitis of small- to medium-sized muscular arteries with lack of granuloma formation that spares veins and pulmonary arteries.

  • Clinical features of PAN depend on...

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