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Vasculitis: Polyarteritis Nodosa

Posted Dec 27 2010 12:00am
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Before the holiday, actually around the beginning of this month ( when I was still employed ) I received an unexpected phone call from the UK from a gentleman who had found my name on the Vasculitis Foundation’s site and he reached out to me asking about symptoms that he was experiencing and he thought that he may have Polyarteritis Nodosa.

As I always have said I am always running across new situations and different vascular conditions and so here is another vascular condition and so just what is Polyarteritis Nodosa?

Polyarteritis nodosa is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries and occasionally affects small muscular arteries, resulting in secondary tissue ischemia.

The kidneys, skin, joints, muscles, peripheral nerves, and GI tract are most commonly affected, but any organ can be. However, the lungs are usually spared.

Patients typically present with systemic symptoms (eg, fever, fatigue). Diagnosis requires a biopsy or arteriography. Treatment with corticosteroids and immunosuppressants is often effective.

So, as usual the first thing that should be noticed as far as treatment for this condition is the always ever popular immunosuppressants and corticosteroids. Below are some signs and symptoms of the disease are listed below…

CNS: Headache and seizures can result. In a few patients, ischemic stroke and cerebral hemorrhage occur, sometimes resulting from hypertension.

GI tract: Vasculitis of the liver or gallbladder causes right upper quadrant pain. Perforation of the gallbladder with acute abdomen may occur. Vasculitis of medium-sized mesenteric arteries causes abdominal pain, nausea, vomiting (with or without bloody diarrhea), malabsorption, intestinal perforation, and acute abdomen. Aneurysms may develop in hepatic or celiac arteries.

Cardiac: Some patients have coronary artery disease, which is usually asymptomatic, but may cause angina. Heart failure may result from ischemic or hypertensive cardiomyopathy

Nervous system: Patients usually present with asymmetric peripheral neuropathy, such as mononeuritis multiplex with signs of motor and sensory involvement of the peroneal, median, or ulnar nerves. As additional nerve branches are affected, patients may appear to have a distal symmetric polyneuropathy.

Some of the ways that this disease can be diagnosed are by Biopsy, or an Arteriography if no clinically involved tissue is available for biopsy.

This condition shows up more in adults than in children, and less in females than males. As with most of the other vascular conditions that we seem to come across is the fact that there is no answer as to what causes the disease in the first place, but in this case it has been reported after cases of  hepatitis B infection.

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