Polyarteritis nodosa is an inflammatory disease of the blood vessels. Small and medium-sized arteries become swollen and damaged when they are attacked by an abnormal response of the immune system.
Causes and Symptoms
The cause of polyarteritis nodosa is unknown. It affects adults more frequently than children.
Symptoms result from damage to body organs, frequently affecting the skin, heart, kidneys, and nervous system. Due to damaged to the blood vessels, the organs receive inadequate blood supply, oxygen and nourishment.
Generalized symptoms include fever, fatigue, weakness, loss of appetite, abdominal pain and weight loss. Muscle and joint aches are common. The skin may show rashes, swelling, ulcers, and lumps.
Nerve involvement may cause sensory changes with numbness, pain, burning, and weakness. Central nervous system involvement may cause strokes or seizures. Kidney involvement can produce varying degrees of renal failure.
Involvement of the arteries of the heart may cause a heart attack, heart failure, and inflammation of the sack around the heart (pericarditis).
There are no specific laboratory to confirm a diagnosis of polyarteritis nodosa. Diagnosis is generally based on a thorough medical history, physical examination and laboratory and imaging studies. Identification and biopsy of the involved tissue is paramount in confirming a diagnosis. Biopsy will often times reveal inflammation of the small arteries.
Treatment involves medications to suppress the immune system, including prednisone and cyclophosphamide.
Current treatments using corticosteroids and other drugs that suppress the immune system (such as cyclophosphamide) can improve symptoms and the chance of long-term organ survival. The most serious complications involve the kidneys, heart, and gastrointestinal tract. Without treatment, the outlook is poor.