Polyarteritis nodosa causes , diagnosis and treatment

Polyarteritis nodosa can occur at any age but usually occur in the 40s and 50s with male : female ratio 2 : 1, it is a necrotizing arteritis, with transmural inflammation affecting medium sized arteries. Etiology 1- Circulating immune complex with low C3, C4 2- Hepatitis HBsAg +ve in 25 % (serum sickness like syndrome), also there is an association with HCv How to diagnose Polyarteritis nodosa ?

Polyarteritis nodosa can occur at any age but usually occur in the 40s and 50s with male : female  ratio 2 : 1, it is a necrotizing arteritis, with transmural inflammation affecting medium sized arteries.

Etiology
1- Circulating immune complex with low C3, C4
2- Hepatitis HBsAg +ve in 25 % (serum sickness like syndrome), also there is an association with HCV.
3- Other viruses are implicated e.g. hepatitis A, CMV, parvovirus.

How to diagnose Polyarteritis nodosa ?

Clinical picture (Vascular occlusion)
Polyarteritis nodosa

1- Kidney (The most common involved organ)
   • Affection of arcuate arteries with narrowing ---7 multiple renal infarcts 7 renal hypertension and renal
impairement.
   • Rapidly progressive glomerulonephr:itis may occur.
   • Spontaneous rupture of aneurysms can result in retroperitoneal hemorrhage or perinephric hematoma.

2- Lung (involvement is rare)
• Pleurisy, lung infiltrates may occur.
3- Skin lesion
• Palpable purpura, infarcts.
• Livedo reticularis, urticaria. • Ulcers.

4- CVS
• Coronary heart disease (angina pectoris or infarction).
• Pericarditis may occur.

5- Nervous system.
• Stroke.
• Mononeuritis multiplex (arteritis in vasa nervorum) .

6- Musculoskeletal:
• Arthralgia, myalgia.

7- Abdomen
• Mesenteric occlusion? acute abdomen.
• Intestinal bleeding.
• Pancreatitis.

Pathology

Lab. Investigations

•  High ESR and  + ve CRP
• Low Hb , platelets increase .
• ANA -ve , if it is positive it is mostly lupus vasculitis !?
• Rh.F -ve , if it is positive it is mostly RA complicated with vasculitis.
• HB s Ag +ve  in 25 %
• Low Cs , C4  (Hypocomplementemia), ANCA is rarely positive.
• Tissue biopsy from the kidney, muscle or sural nerve.
• Eosinophilia.
• Angiography of renal, hepatic or mesenteric arteries showing multiple micro aneurysms.

Treatment
• The recommended initial therapy is prednisone 1-2 mg / kg / d and cyclophosphamide 2- mg. / kg / d, gradual tapering with
improvement, then maintenance therapy to maintain remission.
• Steroid plus interferon if there is positive hepatitis B or C.

COMMENTS

BLOGGER
Name

andrology,2,Cardiology,10,Differential-diagnosis,5,E.N.T,18,General Surgery,4,General-Health,6,GIT,19,Gynecology,1,Hepatology,8,Internal-medicine,1,Microbiology,2,Orthopedics,1,Psychiatry,3,Respiratory-diseases,59,Rheumatology,50,STDs,3,Symptomatology,9,Urology,36,
ltr
item
Med2Date: Polyarteritis nodosa causes , diagnosis and treatment
Polyarteritis nodosa causes , diagnosis and treatment
Polyarteritis nodosa can occur at any age but usually occur in the 40s and 50s with male : female ratio 2 : 1, it is a necrotizing arteritis, with transmural inflammation affecting medium sized arteries. Etiology 1- Circulating immune complex with low C3, C4 2- Hepatitis HBsAg +ve in 25 % (serum sickness like syndrome), also there is an association with HCv How to diagnose Polyarteritis nodosa ?
http://1.bp.blogspot.com/-s5sc78JoBeg/UZ1AuFEB8aI/AAAAAAAAEB8/ldwkYb8vXzY/s1600/Polyarteritis-Nodosa.jpg
http://1.bp.blogspot.com/-s5sc78JoBeg/UZ1AuFEB8aI/AAAAAAAAEB8/ldwkYb8vXzY/s72-c/Polyarteritis-Nodosa.jpg
Med2Date
http://www.med2date.com/2013/05/polyarteritis-nodosa-causes-diagnosis.html
http://www.med2date.com/
http://www.med2date.com/
http://www.med2date.com/2013/05/polyarteritis-nodosa-causes-diagnosis.html
true
1129835733813637495
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy