(PAN; Periarteritis Nodosa)
- Central nervous system (part of the nervous system that includes the brain and spinal cord)
- Peripheral nerves (nerves of the feet, hands, legs, arms, and face)
- Gastrointestinal tract (part of the digestive system that includes the mouth, esophagus, stomach, and intestines)
- Ear, nose, and throat
Skin–polyarteritis nodosa often affects the skin first, especially on the legs, causing:
- Ulcers (open sores on the skin)
- Nodules (small bumps under the skin)
- Gangrene (blood supply to the tissues is stopped, causing the skin to die)
Cut-Away View of Skin with Bruise Copyright © Nucleus Medical Media, Inc.
- Nervous system
- Protein in the urine
- Hypertension (high blood pressure)
- Pain in the abdomen
- Gastrointestinal bleeding
- Bowel infarction (not enough oxygen-rich blood to the bowels causing tissue damage)
- Nausea, vomiting
- Bloody and non-bloody diarrhea
- Detachment of retina
- Scleritis—inflammation in the sclera (white part of the eye)
Detachment of Retina Copyright © Nucleus Medical Media, Inc.
- Testicular infarction (not enough oxygen-rich blood to the testicles causing tissue damage)
- Elevated ESRs ( erythrocyte sedimentation rate ) and CRP ( C-reactive protein )—to measure the degree of inflammation and to monitor inflammatory disease
- CBC ( complete blood count )—to look for elevated white blood count
- Kidney function tests
- Liver function tests
- Hepatitis blood tests
- Immunoglobulins: to look for elevated levels of this blood protein that functions in immunity
- Urine test—to check for protein in the urine
- Skin biopsy —surgical removal of some skin for further examination
- Biopsy of muscles, nerves, kidney, or bowel—surgical removal of a sample of muscle or nerve to see if there is evidence of arterial inflammation in those tissues
Nerve conduction study—to evaluate for muscle or nerve damage
- Your doctor will place small electrodes on your skin over the muscles being tested; electrical signals produced by your nerves and muscles are recorded, and the information is interpreted by a specially-trained physician.
- Arteriogram—dye is injected in arteries, and x-rays are taken that can reveal inflammation within the vascular system
- Corticosteroids—High doses of these steroids, by injection or by mouth, can reduce inflammation of the arteries.
- Immunosuppressive drugs—Suppressing the immune system helps decrease inflammation of the arteries by countering the body’s autoimmune reaction.
- Antiviral drugs—When hepatitis B or C is present, antiviral medications are helpful in addition to immunosuppressive drugs.
Polyarteritis Nodosa Research and Support Network http://www.pansupport.org/
Vasculitis Clinical Research Consortium http://rarediseasesnetwork.epi.usf.edu/vcrc/
Canadian Organization for Rare Disorders http://www.cord.ca/
Canadian Rheumatology Association http://www.rheum.ca/
Beers MH, Berkow R, eds. Diffuse connective tissue disease. The Merck Manual website. Available at: http://www.merck.com/mmpe/index.html. Accessed January 17, 2008.
DynaMed Editorial Team. Polyarteritis nodosa. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 9, 2010. Accessed November 10, 2010.
The Johns Hopkins Vasculitis Center. Types of vasculitis: polyarteritis nodosa. The Johns Hopkins Vasculitis Center website. Available at: http://www.hopkinsvasculitis.org/types-vasculitis/polyarteritis-nodosa . Accessed January 17, 2008.
The Polyarteritis Nodosa Research and Support Network. Polyarteritis nodosa. The Polyarteritis Nodosa Research and Support Network website. Available at: http://www.angelfire.com/pa3/autoimmunedisease/new-pan-index.html. Accessed January 17, 2008.
- Reviewer: Michael J. Fucci, DO
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -