Polyarteritis Nodosa

Last reviewed by Dr.Mary on August 7th, 2018.

What is Polyarteritis Nodosa?

This is a serious disease of unidentified cause that distresses the arteries, which are blood vessels that transports blood that is oxygenated to tissues and organs. It transpires when positive immunization cells attack the arteries which are affected and is referred to as a rare autoimmune disease. This disease affects the small and medium sized arteries which become swollen, inflamed and damaged.

More adults than children come down with this disease. It damages the tissues that are provided for by the arteries which are affected since the tissues are not receiving nourishment and the oxygen they need.

Polyarteritis Nodosa Symptoms

The kinds of symptoms and signs of polyarteritis nodosa differ greatly contingent on the arteries involved. Indicators may be seem in many different parts of the body and many of the difficulties can be severe and even life-threatening.

The sites that are more common for symptoms as well as complications include the nerves, eyes, kidneys, skin, heart, gastrointestinal tract as well as genitals.

Symptoms and complications of polyarteritis nodosa that distress the skin consist of:

Lesions or sores
Nodules
Gangrene
Rashes

Symptoms and complications that distress the eyes can consist of:

Eye and scleritis Inflammation
Eye pain
Blurred vision

Symptoms and complications that distress the nerves consist of:

Tingling
Peripheral neuropathy
Pain in the extremities
Numbness
Lesions of the CNS or central nervous system
Lethargy
Altered mentation
Seizures
Cognitive difficulties

Symptoms and complications that distress the kidneys consist of:

Protein in the urine
Kidney damage
Kidney failure
Hypertension

Symptoms and complications that distress the gastrointestinal tract:

Gastrointestinal Bleeding
Shock
Abdominal pain

Symptoms and complications that distress the heart consist of:

Heart failure
Chest pain
Heart attack
Shortness of breath
Cardiac arrest

Symptoms and complications that distress the genitals consist of:

Testicular pain
Testicular infarction
Swelling
Possible loss of testicle

Polyarteritis Nodosa Causes

Any exact cause or causes of polyarteritis nodosa are not known. But, the following facts about this condition are important.

Occurs twice as often in men than in women
Has been associated with Hepatitis B, A, C virus infections in some patients
Has been associated with methamphetamine use

It is possible that there are many various factors which can disturb the immune system in certain people and the immune system is triggered to cause inflammation of the blood vessel walls. The exact manner in which this occurs is not known but there is medical research being done to look for the exact reason that the immune system is mis-directed.

Polyarteritis Nodosa Diagnosis

Important indications of this condition can be delivered by routine lab test, but there isn’t one single blood test that can make a diagnosis of this illness. Many individuals with polyarteritis nodosa will have an elevated sedimentation ratio and if there is kidney envelopment, protein will be found in urine.

If any muscle, nerve or skin involvement, a muscle/nerve or skin biopsy may be an aid in arriving at a diagnosis for this disease. Conduction nerve studies are one non-invasive process of identifying any nerves distressed by inflammation. These nerves may then also be biopsied in order to verify the diagnosis. The biopsy will show some changes pathologic in the arteries that are medium-sized. Biopsy sites can differ. Many biopsies are frequently taken from symptomatic nerves, muscle or skin. An angiogram of the blood vessels of the abdomen can also be an aid in diagnosing polyarteritis nodosa. Aneurysms can often affect any arteries which are connected to the liver, gastrointestinal tract or kidneys.

“The American College of Rheumatology” or ACR has criteria which has been established which needs to be fulfilled for any individual to be involved in any studies or research of the condition. This criterion is designed to distinguish this disease from other forms of vasculitis. So as to be diagnosed as a patient of this disease – especially for the purposes of research studies, an individual will need to have 3 out of 10 of the following criteria:

Loss of weight of > 4 kg from start of illness
Testicular tenderness or pain
Myalgias, leg tenderness or weakness
Livedo reticularis
Growth of hypertension
Mononeuropathy or polyneuropathy
Raised creatinine or BUN unrelated to obstruction or dehydration
Arteriogram signifying occlusions or aneurysms of the visceral arteries
Existence of hepatitis B surface antibody or antigen in serum
Biopsy of medium and small-sized artery having granulocytes

Polyarteritis Nodosa Treatment

Systemic polyarteritis nodosa in the era of pre-treatment had a terrible prognosis with a five year survival rate of approximately 10%.

Medications now used to treat this condition can include:

High dose intravenous and oral cortisone – such as prednisone
Immunosuppressive drugs: Cyclophosphamide (known as Cytoxan) & Azathioprine (known as Imuran)

As oral cortisone medication begins to work and the sedimentation rates begin to return to normal, gradual tapering of the oral cortisone medication may begin.

When hepatitis B is also present in individuals with polyarteritis, antiviral medication such as: