Polyarteritis nodosa history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.
Overview
History
- Patients with polyarteritis nodosa may have an acute presentation.
- The prodrome of polyarteritis nodosa can range from anywhere between weeks to months.[1]
Polyarteritis nodosa (PAN) is an acute multisystem disease with a relatively short prodrome (ie, weeks to months). Delays in diagnosis are not uncommon. The spectrum of disease ranges from single-organ involvement to fulminant polyvisceral failure. Pertinent and common historical features of polyarteritis nodosa include the following:
Common Symptoms
- Fatigue
- Weakness
- Fever
- Abdominal pain
- Decreased appetite
- Unintentional weight loss
- Muscle aches
- Joint aches
- Skin ulcers
In this disease, symptoms result from damage to affected organs, often the skin, heart, kidneys, and nervous system.
Generalized symptoms include fever, fatigue, weakness, loss of appetite, and weight loss. Muscle and joint aches are common. Cutaneous polyarteritis nodosa most frequently manifests as nodules in the lower legs. They may not leave any residual changes but sometimes livedo reticularis is observed. Ulcerations and splinter hemorrhages are the frequent complications.[2]
Nerve involvement may cause sensory changes with numbness, pain, burning, and weakness.Frequently affected nerves are peroneal, median, ulnar and sural nerves. Central nervous system polyarteritis nodosa presents in three major forms : diffuse encephalopathy, focal neurological deficits and seizures. Diffuse encepahalopathy is characterized by loss of intellectual capacity, disorientation and occasionally psychosis with visual hallucinations. Cerebrovascular accidents in cerebrum, cerebellum or brain stem cause focal defecits.[3]. Kidney involvement can produce varying degrees of renal failure. Arteritis in the renal circulation leads to hypertension. Sometimes patients present with severe flank pain because of renal infarction or rupture of intrarenal aneurysm.
Involvement of the arteries of the heart may cause a heart attack, heart failure, and inflammation of the sac around the heart (pericarditis). Vasculitis of testicular vessels can cause testicular infarction, manifesting as testicular pain or tenderness.[4]
Abdominal pain, weight loss, food avoidance, gastrointestinal bleeding, peritonitis are seen in mesentric vasculitis.[5]
Less Common Symptoms
Reference
- ↑ Stone JH (October 2002). "Polyarteritis nodosa". JAMA. 288 (13): 1632–9. PMID 12350194.
- ↑ Díaz-Pérez JL, De Lagrán ZM, Díaz-Ramón JL, Winkelmann RK (2007). "Cutaneous polyarteritis nodosa". Semin Cutan Med Surg. 26 (2): 77–86. doi:10.1016/j.sder.2007.02.003. PMID 17544958. Unknown parameter
|month=ignored (help) - ↑ Rosenberg MR, Parshley M, Gibson S, Wernick R (1990). "Central nervous system polyarteritis nodosa". West. J. Med. 153 (5): 553–6. PMC 1002622. PMID 1979706. Unknown parameter
|month=ignored (help) - ↑ Meeuwissen J, Maertens J, Verbeken E, Blockmans D (2008). "Case reports: testicular pain as a manifestation of polyarteritis nodosa". Clin. Rheumatol. 27 (11): 1463–6. doi:10.1007/s10067-008-0970-5. PMID 18651100. Unknown parameter
|month=ignored (help) - ↑ Guillevin L, Lhote F, Gallais V; et al. (1995). "Gastrointestinal tract involvement in polyarteritis nodosa and Churg-Strauss syndrome". Ann Med Interne (Paris). 146 (4): 260–7. PMID 7653948.