Polyarteritis nodosa Flashcards
What is the typical clinical presentation of macroscopic and microscopic PAN?
Systemic: malaise, fever, weakness, peripheral neuropathy, arthritis, myalgias, rash (legs), HTN, abdo pain, CVA and MI
What are the usual renal findings with PAN?
Renal insufficiency
HTN
Proteinuria and microhaematuria
Renal infarcts
What will an abdominal angiogram in PAN show?
Aneurysms of large and medium arteries
What would a biopsy of a renal artery in macroscopic polyarteritis nodosa (PAN) show?
Aneurysm formation and infarcts
Significant inflammation of adventitia and thickening of inner layers
Narrowing of arterial lumen
What would a biopsy of a renal artery in microscopic polyarteritis nodosa (PAN) show?
Arteriolar inflammation
Necrotising glomerulonephritis
IF and EM are usually unremarkable for immune complex deposition
What is good management of PAN?
Prednisolone
Cyclophosphamide
What is the prognosis of PAN?
Untreated PAN has a very poor prognosis, 13% at >3 years
80% with treatment
What is the primary pathological process involved in PAN?
Systemic necrotising vasculitis, effecting mostly medium sized muscular arteries
Is PAN associated with antineutrophil cytoplasmic antibodies (ANCA)?
No
What organ system is strikingly spared in PAN?
The lungs
What is the relationship between PAN and HBV and HCV?
The viruses seem to be related to the pathogenesis of PAN in these pts
PAN in these circumstances is called secondary PAN
