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The Hidden Truth About Polyarteritis: Why This Rare Disease Affects Your Kidneys and Heart
Polyarteritis Nodosa (PAN) is a systemic necrotizing vasculitis that mainly affects medium-sized muscular arteries, especially the kidneys and other splanchnic arteries, but usually does not affect the pulmonary vascular circulation. The disease is relatively rare, although in some cases it has been linked to infection with hepatitis B or C. According to research, the five-year survival rate of patients who receive treatment can reach 80%; without treatment, the five-year survival rate is only 13%. Death is usually due to kidney failure, myocardial infarction, or stroke.
Symptoms and signs
Because PAN can affect nearly every organ system, its symptoms and signs are quite diverse. Most of these manifestations result from ischemic damage to affected organs, including the skin, heart, kidneys, and nervous system. According to statistics, more than 90% of patients will experience systemic symptoms, such as fever, fatigue, weakness, loss of appetite and involuntary weight loss.
On the skin, rashes, swelling, necrotic ulcers, and subcutaneous nodules (lumps) may occur.
In the nervous system, nerve damage may cause symptoms such as sensory changes, numbness, pain, burning, and weakness.
Potential complications
Complications of PAN include stroke, heart failure (caused by cardiomyopathy and pericarditis), and intestinal necrosis and perforation. It is quite common for the kidneys to be affected, often resulting in partial kidney failure. Damage to the renal arteries can lead to the development of high blood pressure, and common test results include the presence of protein or blood in the urine.
Cause
PAN is not associated with antineutrophil cytoplasmic antibodies (ANCA), but approximately 30% of patients have chronic hepatitis B virus infection, and HBsAg-HBsAb complexes are detected in affected vessels, indicating that these patients The cause may be related to immune complexes. Other related factors include infection with hepatitis C virus and HIV.
Diagnosis process
There are currently no specific laboratory tests available to diagnose polyarteritis. Diagnosis usually relies on a physical examination and several laboratory tests that help confirm the diagnosis. Generally speaking, patients need to meet more than three of the ten diagnostic criteria provided by the American College of Rheumatology (ACR) in 1990, and research shows that these criteria can help in early identification of the disease in some cases.
Treatment methods
The treatment of PAN usually uses immunosuppressive drugs, such as steroids and cyclophosphamide. If chronic hepatitis B infection is discovered, it should be treated immediately. Some patients may enter remission by starting leflunomide after treatment with rituximab. About 90% of patients will achieve remission or cure after receiving treatment. However, without treatment, the disease eventually leads to death in most patients. According to research, approximately 60% of patients will experience recurrence within five years.
Epidemiology
PAN occurs more frequently in adults and is more common in men. Most cases occur between the ages of 40 and 60, and are more common among people with hepatitis B.
Cultural influence
In the 1956 American film "Bigger Than Life," the protagonist, played by James Mason, was diagnosed with polyarteritis after experiencing severe chest pains and was treated with cortisone.
Understanding the potential impact of polyarteritis in today's society will help bring more attention to this rare condition and promote early diagnosis and effective treatment. Are you ready to take care of your health, especially the health of your kidneys and heart?
