Polyarteritis Nodosa Flashcards
What is polyarteritis nodosa?
- necrotising inflammation of medium sized arteries without glomerulonephritis or vasculitis in arterioles, venules or capillaries
- aneurysms lead to thrombosis and infarction
What is the cause of polyarteritis nodosa?
- HBV is thought to be a common cause
2. but has decreased due to vaccination
What is epid of polyarteritis nodosa?
middle aged men
What are the skin manifestations of polyarteritis nodosa?
- rash
- punched out ulcers
- nodules
What are the renal manifestations of polyarteritis nodosa?
- artery narrowing
- ischaemia
- HTN
What are the GI manifestations of polyarteritis nodosa?
- abdominal pain
2. melaena
What are key symptoms of polyarteritis nodosa?
- Livedo reticularis
- Systemic features present
- Skin (rash, punched out ulcers, nodules)
- Renal (artery narrowing, ischaemia, HTN)
- Cardio
- GI (abdominal pain, melaena)
What investigations are done for polyarteritis nodosa?
- FBC
- HBV serology
- ESR/CRP
- MRA
- Renal biopsy
What does FBC show in polyarteritis nodosa?
elevated WCC
What does HBV serology show in polyarteritis nodosa?
possible HbsAg +ve
What does ESR/CRP show in polyarteritis nodosa
elevated
What else do you get livedo reticularis with?
anti-phospholipid syndrome
What does MRA show in polyarteritis nodosa?
- Innumerable microaneurysms and spasm
2. string of pearls appearance
What does renal biopsy show in polyarteritis nodosa?
- Focal transmural inflammation
2. Fibrinoid necrosis
What is the management of polyarteritis nodosa?
prednisolone, if severe add DMARD
