Polyarteritis nodosa Health Article

Definition

Polyarteritis nodosa is a serious blood vessel disease in which small and medium-sized arteries become swollen and damaged.

Alternative Names

Periarteritis nodosa

Causes, incidence, and risk factors

Polyarteritis nodosa is a disease of unknown cause that affects arteries, the blood vessels that carry oxygenated blood to organs and tissues. It occurs when certain immune cells attack the affected arteries.

More adults than children get this disease. It damages the tissues supplied by the affected arteries because the tissues aren't receiving the oxygen and nourishment they need.

In this disease, symptoms result from damage to affected organs, often the skin, heart, kidneys, and nervous system.

Generalized symptoms include fever, fatigue, weakness, loss of appetite, 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 (kidney) failure.

When heart arteries are involved, heart attack, heart failure, and inflammation of the sack around the heart (pericarditis) can occur.

Symptoms

• Abdominal pain
• Decreased appetite
• Fatigue
• Fever
• Joint aches
• Muscle aches
• Unintentional weight loss
• Weakness

Signs and tests

There are no specific lab tests for diagnosing polyarteritis nodosa. Diagnosis is based on the physical examination and a few laboratory studies that help to confirm the diagnosis:

• CBC may show a higher-than-normal white blood count.
• ESR or CRP is often higher than normal.
• Tissue biopsy reveals inflammation in small arteries, called arteritis.
• Immunoglobulins may be increased.

Treatment

Treatment involves medications to suppress the immune system, including prednisone and cyclophosphamide.

Expectations (prognosis)

Current treatments using steroids and other drugs that suppress the immune system (such as cyclophosphamide) can improve symptoms and the chance of long-term survival. The most serious associated conditions generally involve the kidneys and gastrointestinal tract. Without treatment, the outlook is poor.