Polyarteritis nodosa natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
==Natural History== | ==Natural History== | ||
Untreated, the disease is fatal in most cases. The most serious associated conditions generally involve the [[kidneys]] and [[gastrointestinal tract]]. Without treatment, the outlook is poor. | Untreated, the [[disease]] is fatal in most cases. The most serious associated conditions generally involve the [[kidneys]] and [[gastrointestinal tract]]. Without treatment, the outlook is poor. | ||
==Complications== | ==Complications== | ||
Complications include the following: | Complications include the following: | ||
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* [[Kidney failure]] | * [[Kidney failure]] | ||
* [[myocardial infarction|Heart attack]] | * [[myocardial infarction|Heart attack]] | ||
* Intestinal [[necrosis]] and perforation | * [[Intestinal]] [[necrosis]] and [[perforation]] | ||
==Prognosis== | ==Prognosis== | ||
Therapy results in remissions or cures in 90% of cases. Current treatments using steroids and other drugs that suppress the immune system (such as [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival. Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another [[Immunosuppressive therapy|immunosuppressive]] drug in addition to [[prednisone]]. | Therapy results in remissions or cures in 90% of cases. Current treatments using [[steroids]] and other drugs that suppress the [[immune system]] (such as [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival. Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another [[Immunosuppressive therapy|immunosuppressive]] drug in addition to [[prednisone]]. | ||
# [[Proteinuria]] >1g/day | # [[Proteinuria]] >1g/day | ||
#[[Azotemia]] | #[[Azotemia]] | ||
#[[Cardiomyopathy]] | #[[Cardiomyopathy]] | ||
#[[Gastrointestinal]] involvement | #[[Gastrointestinal]] involvement | ||
#[[Central nervous system]] disease | #[[Central nervous system]] disease With none of these factors, 5-year mortality is 12%. With 2 or more 5-year mortality is 46%<ref>Kelley's Textbook of Rheumatology,8th edition</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 16:01, 7 April 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.
Overview
Natural History
Untreated, the disease is fatal in most cases. The most serious associated conditions generally involve the kidneys and gastrointestinal tract. Without treatment, the outlook is poor.
Complications
Complications include the following:
Prognosis
Therapy results in remissions or cures in 90% of cases. Current treatments using steroids and other drugs that suppress the immune system (such as cyclophosphamide) can improve symptoms and the chance of long-term survival. Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another immunosuppressive drug in addition to prednisone.
- Proteinuria >1g/day
- Azotemia
- Cardiomyopathy
- Gastrointestinal involvement
- Central nervous system disease With none of these factors, 5-year mortality is 12%. With 2 or more 5-year mortality is 46%[1]
References
- ↑ Kelley's Textbook of Rheumatology,8th edition