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Did you know how polyarteritis causes strange purple spots and bumps on the skin?
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that primarily affects medium-sized smooth muscle arteries, which usually include arteries of the kidneys and other viscera, but blood circulation in the lungs is usually not affected. Influence. Of note, the disease is sometimes associated with infection with the hepatitis B or hepatitis C viruses. Polyarteritis can also occur in infants, and its rarity makes diagnosis and treatment challenging.
Without treatment, the five-year survival rate is only 13%; with treatment, it can increase to 80%.
Symptoms and manifestations
Polyarteritis may affect almost any organ system, so it presents with a wide variety of symptoms. The main manifestation is from ischemic damage to the affected organs. Commonly affected areas include the skin, heart, kidneys and nervous system.
Skin symptoms
Skin changes may appear as rashes, swelling, necrotic ulcers, and subcutaneous nodules. Many patients develop palpable purpura and reticular purpura.
Nervous system
Damage to the nervous system may result in sensory changes such as numbness, pain, burning, and weakness, which often manifest as polyneuritis, the most common neurological sign in polyarteritis.
Kidney
Kidney damage is common and may eventually lead to partial kidney necrosis. Involvement of the renal arteries can lead to hypertension, which occurs in about one-third of cases. Almost all patients with polyarteritis have renal insufficiency.
Cardiovascular system
Damage to the arteries in the heart can lead to conditions such as heart attack, heart failure and pericarditis.
Digestive system
The intestinal system may cause abdominal pain, mesenteric ischemia and intestinal perforation due to damage to the mesenteric artery.
Musculoskeletal system
Muscle and joint pain are also very common in this condition.
Cause and diagnosis
The cause of polyarteritis is still unknown. Some cases are related to chronic hepatitis B virus, but about 30% of patients with polyarteritis have chronic hepatitis B.
Diagnosis often relies on the patient's clinical manifestations and several laboratory tests, such as complete blood count (CBC) showing elevated white blood cell count, elevated erythrocyte sedimentation rate (ESR), etc. To be diagnosed, patients need to meet three 1990 American College of Rheumatology (ACR) criteria.
Treatment and Prognosis
Treatment mainly includes immunosuppressive drugs such as fluclothiopent and cyclophosphamide. In some cases, adjuvant therapy with methotrexate or levofluorine may also be used.
90% of patients who receive treatment achieve remission or cure, however untreated polyarteritis is often fatal.
Epidemiology
Polyarteritis is more common in adults than in children, and affects more men than women. It is more common in the age group of 40 to 60 years old. The number of patients with polyarteritis is more significant than those with hepatitis B infection.
Cultural influence
In the 1956 American film Larger than Life, a character is diagnosed with polyarteritis and treated with cortisone after experiencing severe chest pains.
As a rare and potentially fatal disease, polyarteritis leaves many people confused about its causes and effects. Do we know enough to deal with this hidden and dangerous disease?
