Polyarteritis nodosa (PAN)
What is it?
Panarteritis nodosa was the first vasculitis described in 1854.
It is characterized by full-thickness inflammation and necrosis of short sections of the wall of arterial vessels that supply blood to the intestines, kidneys, muscles, peripheral nerves, skin, and heart. More recently, a form has been discovered that affects both arterial and venous vessels of small caliber (microscopic polyangiitis), and also causes rapidly progressive glomerulonephritis.
Causes and risk factors
The disease is very rare. Two out of three patients are men, most often between the ages of 40 and 60.
Which are the symptoms?
Clinically, polyarteritis can manifest itself with pictures of varying severity: from forms of the disease limited to the skin (palpable purpura, ulcers and lyreticular nodes, subcutaneous nodules), to a picture of a widespread disease, which, if left untreated, can be fatal.
In a diffuse form appear:
- weight loss;
- signs of poor perfusion of the affected organs (peripheral polyneuropathy, arterial hypertension and necrotizing glomerulonephritis).
The involvement of the gastrointestinal system is manifested by abdominal pain and diarrhea or, in severe cases, bleeding from intestinal perforation. Damage to the coronary arteries can lead to a heart attack. There is no definitive laboratory test for diagnosis, although anti-cytoplasmic autoantibodies of neutrophil granulocytes (ANCA) are often positive on microscopic examination.
How is it diagnosed?
It is important to have a biopsy that looks for vasculitis and an angiography that looks for characteristic small aneurysms.
How is it treated?
With the use of high doses of corticosteroids, to which it is often necessary to prescribe powerful immunosuppressants from the very beginning (azathioprine, cyclophosphamide).
Where do we treat it?
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