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Polyarteritis Nodosa

Katherine S. Upchurch, MD and De Ann Williams, MBBS Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Polyarteritis nodosa (PAN) is an antineutrophil cytoplasmic antibody (ANCA)-negative necrotizing arteritis of medium or small arteries without glomerulonephritis or vasculitis of art...

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 ski...

TREATMENT

GENERAL MEASURES

Aggressively treat HTN to prevent associated complications (stroke, myocardial infarction, heart failure). 

MEDICATION

First Line

  • Severe (life-threatening) disease: corticostero...

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.

  • Be alert for:

    • Side ef...

REFERENCES

1
Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum.  2013;65(1):1–11. [View Abstract on ...

ADDITIONAL READING

Samson M, Puéchal X, Mouthon L, et al; for the French Vasculitis Study Group. Microscopic polyangiitis and non-HBV polyarteritis nodosa with poor prognosis factors: 10-year results ...

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

ICD9

446.0 Polyarteriti...

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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