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- $Unique_ID{BRK04116}
- $Pretitle{}
- $Title{Polyarteritis Nodosa}
- $Subject{Polyarteritis Nodosa PAN Periarteritis Polyarteritis Wegener's
- Granulomatosis Churg-Strauss Syndrome Takayasu's Arteritis Giant Cell
- Arteritis Cogan's Syndrome}
- $Volume{}
- $Log{}
-
- Copyright (C) 1989, 1993 National Organization for Rare Disorders, Inc.
-
- 666:
- Polyarteritis Nodosa
-
- ** IMPORTANT **
- It is possible that the main title of the article (Polyarteritis Nodosa)
- is not the name you expected. Please check the SYNONYM listing to find the
- alternate names and disorder subdivisions covered by this article.
-
- Synonyms
-
- PAN
- Periarteritis
- Polyarteritis
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Wegener's Granulomatosis
- Churg-Strauss Syndrome
- Takayasu's Arteritis
- Giant Cell Arteritis
- Cogan's Syndrome
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Polyarteritis Nodosa is characterized by an inflammation of the arteries
- causing narrowing of the vessels. This may result in lack of blood supply to
- tissues, possible formation of blood clots (thrombosis), and weakening,
- ballooning (aneurysm) or possible rupture of vessel walls.
-
- Symptoms
-
- Polyarteritis Nodosa affects the arteries. Joint, muscle, abdominal and
- testicular pain may occur. The patient may also have fever, weight loss and
- high blood pressure (hypertension). The kidney is the organ most often
- involved. The lungs are rarely affected.
-
- Skin rash may be present and gastrointestinal symptoms such as abdominal
- pain, vomiting of blood (hematemesis) and tender abdomen may be present.
-
- Causes
-
- The exact cause of Polyarteritis Nodosa is not known. In the majority of
- patients no predisposing cause has been found. Unidentified bacterial and/or
- viral infections may be a cause. Polyarteritis Nodosa has been observed in
- drug abusers, particularly those using amphetamines, and in patients with
- Hepatitis B (infection of the liver). (For more information on this
- disorder, choose "Hepatitis B" as your search term in the Rare Disease
- Database.) This disorder has also been linked to an allergic reaction to
- some drugs and vaccines.
-
- Most scientists believe that Polyarteritis Nodosa is an autoimmune
- disease. Autoimmune disorders are caused when the body's natural defenses
- against invading organisms (antibodies) suddenly begin to attack perfectly
- healthy tissue. Treatment of Polyarteritis Nodosa usually involves drugs
- that alter the immune system.
-
- Recent research suggests that a bacterial infection may initially trigger
- onset of Polyarteritis Nodosa causing an abnormal immune response to
- infection.
-
- Affected Population
-
- Polyarteritis Nodosa usually affects people between 40 to 50 yrs. of age, but
- it may occur in any age group. It affects approximately 1 in 100,000 people.
- Men appear to be affected two to three times more often than women.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Polyarteritis
- Nodosa. Comparisons may be useful for a differential diagnosis:
-
- Wegener's Granulomatosis occurs in the 4th or 5th decade of life and has
- a slight male preponderance. It typically involves the upper and lower
- respiratory tracts and kidney. This disorder usually progresses into a
- generalized inflammation of the blood vessels and kidney. (For more
- information on this disorder, choose "Wegener" as your search term in the
- Rare Disease Database).
-
- Churg-Strauss Syndrome is a lung disorder often occuring as a
- complication of other disorders. Allergic blood vessel inflammation
- (angiitis or vasculitis) is usually accompanied by many inflammatory nodular
- lesions. (For more information on this disorder, choose "Churg-Strauss" as
- your search term in the Rare Disease Database).
-
- Takayasu Arteritis (Aortic Arch Syndrome) is an inflammation of the walls
- of large and midsized arteries followed by fibrosis and thickening. It
- affects mainly women. (For more information on this disorder, choose
- "Takayasu" as your search term in the Rare Disease Database).
-
- Giant Cell Arteritis is a disease that affects the large arteries and
- occasionally the small ones. Cranial arteries are often affected causing
- headaches, and scalp tenderness. (For more information on this disorder,
- choose "Giant Cell Arteritis" as your search term in the Rare Disease
- Database).
-
- Cogan's Syndrome is a very rare polyarteritis-type disorder. It is
- characterized by interstitial keratitis, vertigo, tinnitus, and hearing loss.
- This is often associated with other systemic disease symptoms such as:
- congestive heart failure, intestinal hemorrhage, enlarged spleen, high blood
- pressure, and muscle and bone symptoms. Treatment may consist of the use of
- corticosteroid drug therapy and when started early in the disease can result
- in clearing of inflammed eyes and in hearing recovery. Other symptoms may
- respond to treatment specific to that disorder. Cogan's Syndrome can occur
- at any age and affects men and women equally.
-
- Therapies: Standard
-
- Treatment of Polyarteritis Nodosa usually consists of the use of
- corticosteroid drugs, such as Prednisone, to suppress the immune system and
- relieve inflammation. Cyclophosphamide has also been used to suppress the
- immune system. Treatment for control of hypertension may also be indicated.
- Surgical intervention is sometimes required in cases of gastrointestinal
- involvement. Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Plasmapheresis may be of benefit in some cases of Polyarteritis Nodosa. This
- procedure is a method for removing unwanted substances (toxins, metabolic
- substances and plasma parts) from the blood. Blood is removed from the
- patient and blood cells are separated from plasma. The patient's plasma is
- then replaced with other human plasma and the blood is retransfused into the
- patient. This therapy is still under investigation to analyze side effects
- and effectiveness. More research is needed before plasmapheresis can be
- recommended for use in all but the most severe cases of Polyarteritis Nodosa.
-
- The National Institute of Allergy and Infectious Diseases is conducting a
- study on a treatment for Polyarteritis Nodosa. Patients who wish to
- participate in the clinical trials must be at least 14 years of age and had a
- recent onset of illness. For further information, physicians may contact:
-
- Dr. Gary S. Hoffman or Dr. Randi Y. Levitt
- NIH/National Institute of Allergy and Infectious Diseases (NIAID)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-1124
-
- This disease entry is based upon medical information available through
- March 1993. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Polyarteritis Nodosa, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Allergy and Infections Diseases (NIAID)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5717
-
- References
-
- INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
- Co., 1987. Pp. 856., 857, 1282-1284.
-
- PULMONARY DISEASES AND DISORDERS, 2nd Ed.: A.P. Fishman, M.D.; McGraw-
- Hill, 1988. Pp. 1127-28.
-
- CLINICAL FINDINGS AND PROGNOSIS OF POLYARTERITIS NODOSA AND CHURG-STRAUSS
- ANGIITIS; A STUDY IN 165 PATIENTS. L. Guillevin, et al.; Br. J.
- Rheumatology, Aug. 1988., (issue 27(4)). Pp. 258-64.
-
- IMMUNOSUPPRESSIVE AND CORTICOSTEROID THERAPY OF POLYARTERITIS NODOSA.
- E.S. Leib, et al.; Am. J. Med., Dec., 1979 (issue 67(6)). Pp. 941-7.
-
-