Polyarteritis nodosa historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3] Cafer Zorkun, M.D., Ph.D. [4]; Haritha Machavarapu, M.B.B.S.
Overview
Historical Perspective
- Polyarteritis nodosa is also called Kussmaul disease or Kussmaul-Meier disease after Kussumaul and Maier, who first described the syndrome in 1866.
- PAN was first described macroscopically by the pathologist K. Rokitansky in 1842.
- He described the presence of aneurysms macroscopically and therefore missed the inflammatory nature of this disease [1].
- PAN was better described in 1866 by A. Kussmaul and R. Maier who provided a clinical description of a patient.
- He included a post-mortem histological examination of blood vessels of the patient, arriving at a diagnosis of vasculitis.
- Kussmaul and Maier introduced the term “periarteritis nodosa” to describe the nodules observed in intermediate-sized vascular arteries but this term was later changed to “Polyarteritis nodosa” when these nodules showed the involvement of all layers of the artery [2].
- In 1931, Dr. Lindberg became the first person to recognize PAN limited to skin [3]. In 1970, Trepo and Thivolet reported the association of PAN with hepatitis B virus (HBV) infection [4], later it became obvious that most PAN cases were associated with HBV.
The etiology of Polyarteritis nodosa remains unknown till date. There are no clear cut causative factors of the disease, no definitive serological diagnostic testing for it and no specified pathognomonic features for polyarteritis nodosa. Therefore, the term “Polyarteritis Nodosa” is often used for any immunologically mediated systemic vasculitis.
References
- ↑ Tesar V, Kazderová M, Hlavácková L (2004). "Rokitansky and his first description of polyarteritis nodosa". J Nephrol. 17 (1): 172–4. PMID 15151275.
- ↑ Kluge FJ, Matteson EL (2003). "[Think clearly, be sincere, act calmly: Adolf Kussmaul (1822-1902) un his significance for medicine in the 21st century]". Z Rheumatol. 62 (5): 484–90. doi:10.1007/s00393-003-0536-5. PMID 14579038.
- ↑ BOSS J (1945). "[Not Available]". Schweiz Z Tuberk. 2 (2): 89–108. PMID 21008159.
- ↑ Trepo C, Thivolet J (1970). "Hepatitis associated antigen and periarteritis nodosa (PAN)". Vox Sang. 19 (3): 410–1. PMID 4396040.