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Polyarteritis nodosa, PAN, Panarteritis, or periarteritis nodosa
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- In this condition (PAN), the medium and small arteries that carry blood to the organs of the body become swollen and damaged (inflammation).
- PAN is classified as an autoimmune disease in which the body's own defenses (white blood cells, Proteins, or antibodies) attack the arteries in the organs.
- Complications of PAN involve damage to other organs including the skin, kidneys, gut or GI tract, joints, muscles, heart, nerves, brain, testes, and ovaries. The lungs are rarely affected.
Cause
- Unknown, but autoimmunity is suspected
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- Fever
- Fatigue
- Headache
- Muscle aches (myalgia)
- Joint aches (arthralgia)
- Weight loss
- Rash
- Bleeding under the skin
- Lumps -- nodes
- Muscle aches
- Joint aches
- High Blood Pressure
- Headache
- Pinkish urine -- Hematuria or Blood in the Urine
- Fatigue
- Weakness
- Abdominal pain
- Nausea
- Vomiting
- Bleeding -- vomiting blood, bloody stool
- Shortness of breath
- Swelling of ankles
- Heart attack
- Fatigue
- High Blood Pressure
- Nervous system -- brain and nerves:
- Seizures
- Stroke
- Numbness
- Confusion
- Headache
- Blood clots
- Lung problems -- cough, shortness of breath, coughing up blood (hemoptysis)
- Pain in the testes
- Pain in the lower part of the abdomen over the ovaries
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- Symptoms
- Illnesses
- Surgeries
- Medications
- Allergies
- Habits
- Occupation
- May reveal lumps or nodes
- Livedo reticularis is a purplish discoloration over the skin of arms, legs, or torso.
- Blood pressure is elevated (>90mm Hg)
- Weight loss may be present (>4 Kg.)
- Muscle weakness or wasting may be present.
- Ankle swelling may be seen.
- Heart and lung sounds may be abnormal or diminished.
- There may be areas of numbness in the skin.
- Testicles may be painful or tender.
- Abdominal tenderness may be present.
- Blood:
- Elevated number of white blood cells especially neutrophils or eosinophils
- Elevated ESR and C-reactive proteins
- Elevated levels of antibodies (e.g., IgM)
- Presence of Hepatitis B antigen (sign of possible PAN infection)
- Anemia or low hemoglobin or low blood
- Abnormal liver and kidney functions
- Red blood cells.
- Chest X-Ray will show round scars (areas of inflammation) known as granulomas in the lungs.
- Biopsy -- done by taking a sample of the damaged tissue.
- The piece biopsied will show inflammation of the small and medium arteries.
- Angiogram -- done by injecting a dye into the arteries, then taking a Radiograph (X-Ray). The angiogram will show the segments of the artery affected by PAN.
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- There may be an association with Hepatitis B virus infection.
- Male > female
- Average age of incidence around 45
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- Depends on the degree of disease and organs involved
- Low salt diet for High Blood Pressure
- Dialysis (machine that filters the blood) for kidney failure
- Medications such as Prednisone or Cyclophosphamide will decrease inflammation of the arteries.
- Plasmapheresis -- filters the blood and removes harmful antibodies.
- Consider Hepatitis B vaccine
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Contact your doctor. PAN may be fatal if left untreated.
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