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: | ||
* [[Stroke]] | ** [[Stroke]] | ||
* [[Kidney failure]] | ** [[Kidney failure]] | ||
* [[myocardial infarction|Heart attack]] | ** [[myocardial infarction|Heart attack]] | ||
* [[Intestinal]] [[necrosis]] | ** [[Intestinal]] [[necrosis]] | ||
** [[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]] | ||
Revision as of 14:27, 11 May 2018
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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