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Polyarteritis Nodosa, Pediatric

Jay Mehta, MD, MS Reviewed 10/2018
 


BASICS

DESCRIPTION

An inflammatory process of small- and medium-sized muscular arteries resulting in multi-system organ dysfunction 

EPIDEMIOLOGY

Incidence

Extremely rare in childhood 

Prevalence

Prevalence...

DIAGNOSIS

HISTORY

  • Persistent constitutional symptoms

  • Bilateral calf pain and other myalgia

  • Abdominal pain

  • Weight loss

  • Unexplained fever

  • Headache

  • Arthralgia

  • Rashes

  • Seizures

  • Weakness

PHYSICAL EXAM

  • Check skin for th...

TREATMENT

MEDICATION

  • Ideally, diagnosis established with angiography or biopsy before beginning treatment

  • Corticosteroids are mainstay.

    • Usually start at dose of oral prednisone 1 to 2 mg/kg/24 h and adju...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Watch for the following:

    • Rising creatinine and BUN levels

    • Abdominal pain

      • Severe abdominal pain suggests peritoneal bleed.

    • Chest pain or cardiac dysf...

ADDITIONAL READING

  • Eleftheriou D, Dillon MJ, Tullus K, et al. Systemic polyarteritis nodosa in the young: a single-center experience over thirty-two years. Arthritis Rheum.  2013;65(9):2476–2485....

CODES

ICD9

446.0 Polyarteritis nodosa 

ICD10

M30.0 Polyarteritis nodosa 

SNOMED

  • 155441006 Polyarteritis nodosa (disorder)

  • 239926000 Cutaneous polyarteritis nodosa

  • 239925001 Polyarteritis nodosa with single o...

FAQ

  • Q: When should I consider polyarteritis nodosa in the differential?

  • A: There are five major clues to polyarteritis nodosa: (i) prolonged constitutional symptoms without a diagnosis, (ii) multisyste...

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