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Polyarteritis nodosa
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Polyarteritis nodosa

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Periarteritis nodosa

Polyarteritis nodosa is a serious blood vessel disease. The small and medium-sized arteries become swollen and damaged.

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  • Causes

    Arteries are the blood vessels that carry oxygen-rich blood to organs and tissues. The cause of polyarteritis nodosa is unknown. The condition occurs when certain immune cells attack the affected arteries.

    More adults than children get this disease. The tissues that are fed by the affected arteries do not get the oxygen and nourishment they need. Damage occurs as a result.

    People with active hepatitis B or hepatitis��C may develop this disease.

  • Symptoms

    Symptoms are caused by damage to affected organs. The skin, joints, muscle, gastrointestinal tract, heart, kidneys, and nervous system are often affected.

    Symptoms include:

    • Abdominal pain
    • Decreased appetite
    • Fatigue
    • Fever
    • Joint aches
    • Muscle aches
    • Unintentional weight loss
    • Weakness

    If nerves are affected, you may have numbness, pain, burning, and weakness. Damage to the nervous system may cause strokes or seizures.

  • Exams and Tests

    No lab tests are available to diagnose polyarteritis nodosa. You will have a physical exam.

    Lab tests that can help make the diagnosis include:

    • Arteriogram
    • Complete blood count (CBC), creatinine, tests for hepatitis B and C, and urinalysis
    • Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
    • Tissue biopsy
    • Other blood tests may be done to rule out similar conditions, such as systemic lupus erythematosus (ANA) or granulomatosis with polyangiitis (ANCA).
  • Treatment

    Treatment involves medicines to suppress the immune system. These may include steroids, such as prednisone. Similar medicines, such as azathioprine, methotrexate or mycophenolate that allow for reducing the dose of steroids are often used as well. Cyclophosphamide is used in severe cases.

    For polyarteritis nodosa related to hepatitis, treatment may involve plasmapheresis and antiviral medicines.

  • Outlook (Prognosis)

    Current treatments with steroids and other drugs that suppress the immune system (such as azathioprine or cyclophosphamide) can improve symptoms and the chance of long-term survival.

    The most serious complications usually involve the kidneys and gastrointestinal tract.

    Without treatment, the outlook is poor.

  • Possible Complications


    • Heart attack
    • Intestinal necrosis and perforation
    • Kidney failure
    • Stroke
  • When to Contact a Medical Professional

    Call your health care provider if you develop symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome.

  • Prevention

    There is no known prevention. However, early treatment can prevent some damage and symptoms.

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References

Sergent JS. Polyarteritis and related disorders. In: Harris ED Jr., Budd RC, Genovese MC, Firestein GS, Sargent JS, eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, PA: Saunders Elsevier; 2008: chap 83.

Stone JH. The systemic vasculitides. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011: chap 278.

Ribi C, Cohen P, Pagnoux C, et al. Treatment of polyarteritis nodosa and microscopic polyangiitis without poor-prognosis factors: A prospective randomized study of one hundred twenty-four patients. Arthritis Rheum. 2010; 62:1186-1197.

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Review Date: 8/3/2014  

Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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