Vasculitis: Polyarteritis nodosa

Question 1

Definition

Answer 1

Immune cells directly attack the endothelium, confusing it with hepatitis B virus.
- Affect muscular arteries which supply a wide range of organs
- Causes transmural inflammation
- Fibrosis occurs as the vascular wall heals, and this process is called fibrinoid necrosis
- More prone to aneurysm and on imaging look like a string of beads

Question 2

Signs

Answer 2

Renal arteries = HTN
Mesenteric arteries = mesenteric ischaemia + severe epigastric abdominal pain + GI bleeding
Skin lesions

Question 3

Treatment

Answer 3

Corticosteroids = PREDNISOLONE

Question 4

Buerger’s disease

Answer 4

Vasculitis which causes blood clots in tiny arteries in the fingers and toes, which leads to ulcers and eventually dead tissue in these digits and eventual autoamputation.

Typically affects men between the ages of 20 and 40 years
Risk factor for this vasculitis is the use of tobacco products.

Stopping the use of tobacco actually slows down (but doesn’t necessarily stop) the disease and need for amputations in most patients.