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Polyarteritis Nodosa

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Comprehensive Therapy

Abstract

Polyarteritis nodosa, as a diagnosis, has been progressively narrowed from a collection of ill-defined vasculitides to its current definition as a systemic transmural necrotizing vasculitis that usually affects medium-sized muscular arteries and sometimes small muscular arteries, commonly within the kidneys, gastrointestinal tract, skin, nerves, joints, and muscles. In this review, we will highlight the clinical features and classification of this disease and emphasize that more accurate diagnosis of subtypes leads to more effective treatment.

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References

  1. Balow JE. Renal vasculitis. Kidney Int 1985;27:954–64.

    Article  PubMed  CAS  Google Scholar 

  2. Chanseaud Y, Tamby MC, Guilpain P, Reinbolt J, Kambouchner M, Boyer N, et al. Analysis of autoantibody repertoires in small- and medium- sized vessels vasculitides. Evidence for specific perturbations in polyarteritis nodosa, microscopic polyangiitis, Churg-Strauss syndrome and Wegener’s granulomatosis. J Autoimmun 2005 Mar;24(2):169–79.

    Article  CAS  Google Scholar 

  3. Cotran RS, Kumar V, Collins T. Robbins pathologic basis of disease. 6th ed. Philadelphia, PA: Saunders; 1999. p. 520.

    Google Scholar 

  4. Fauci AS, Katz P, Haynes BF, et al. Cyclophosphamide therapy of severe systemic necrotizing vascultitis. N Engl J Med 1979;301:235–8.

    Article  PubMed  CAS  Google Scholar 

  5. Flaherty J, Bradley EL. Acute pancreatitis as a complication of polyarteritis nodosa. Ing J Pancreatol 1999;25:53–7.

    CAS  Google Scholar 

  6. Frankel SK, Sullivan EJ, Brown KK. Vasculitis: Wegener granulomatosis, Churg–Strauss syndrome, microscopic polyaniitis, polyarteritis nodosa, and Takayasu arteritis. Crit Care Clin 2002;18:855–79.

    Article  PubMed  Google Scholar 

  7. Frohnert PP, Sheps SG. Long-term follow-up study of periarteritis nodosa. Am J Med 1967;43:8–14.

    Article  PubMed  CAS  Google Scholar 

  8. Gayraud M, Guillevin L, le Toumelin P, et al. Long-term follow up of polyarteritis nodosa, microscopic polyangiitis, and Churg–Strauss syndrome. Arthritis Rheum 2001;44:666–75.

    Article  PubMed  CAS  Google Scholar 

  9. Gibson LD, Su WP. Cutaneous vasculitis. Rheum Dis Clin North Am. 1995;21:1097.

    PubMed  CAS  Google Scholar 

  10. Guillevin L, Lhote F. Distinguishing polyarteritis nodosa from microscopic polyangiitis and implications for treatment. Curr Opin Rheumatol 1995;7:20–4.

    PubMed  CAS  Google Scholar 

  11. Haugeberg G, Bie R, Bendvold A, et al. Primary vasculitis in a Norwegian community hospital: a retrospective study. Clin Rheumatol 1998;17:364–8.

    Article  PubMed  CAS  Google Scholar 

  12. Hsu CT, Kerrison JB, Miller NR, et al. Choroidal infarction, anterior ischemic optic neuropathy, and central retinal artery occlusion from polyarteritis nodosa. Retina 2001;21:348–51.

    Article  PubMed  CAS  Google Scholar 

  13. Hunder GG, Stone JH. Treatment and prognosis of polyarteritis nodosa. Up to date. January 19th, 2006.

  14. Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides: The proposal of an international consensus conference. Arthritis Rheum 1994;37:187–92.

    Article  PubMed  CAS  Google Scholar 

  15. Kastner D, Gaffney M, Tak T. Polyarteritis nodosa and myocardial infarction. Can J Cardiol 2000;16:515–8.

    PubMed  CAS  Google Scholar 

  16. Kato T, Fujii K, Ishii E, et al. A case of polyarteritis nodosa with lesions of the superior mesenteric artery illustrating the diagnostic usefulness of three-dimensional computed tomographic angiography. Clin Rheumatol 2005;24:628–31.

    Article  PubMed  Google Scholar 

  17. Kawasaki T. MLNS showing particular skin desquamation from the finger and toe in infants. Allergy 1967;16:178–89.

    PubMed  CAS  Google Scholar 

  18. Kirkland GS, Savige J, Wilson D, et al. Classical polyarteritis nodosa and microscopic polyarteritis with medium vessel involvement—a comparison of the clinical and laboratory features. Clin Nephrol 1997;47:176–80.

    PubMed  CAS  Google Scholar 

  19. Kussmaul A, Maier R. Uber eine bisher nicht beschreibene eigenthumliche Arterienerkrankung (Periarteriitis nodosa), die mit Morbus Brightii und rapid fortscreinetender allgemeiner Muscellahmung einhergeht. Dtcsh Arch Klin Med 1866;1:484–518.

    Google Scholar 

  20. Leib ES, Restivo C, Paulus HE. Immunosuppressive and corticosteroid therapy of polyarteritis nodosa. Am J Med 1979;67:941–7.

    Article  PubMed  CAS  Google Scholar 

  21. Levine SM, Hellmann DB, Stone JH. Gastrointestinal involvement in polyarteritis nodosa (1986–2000): presentation and outcomes in 24 patients. Am J Med 2002;112:386–91.

    Article  PubMed  Google Scholar 

  22. Lightfoot RW, Michel BA, Bloch DA, Hunder GG, Zvaifler NJ, McShane DJ, Arend WP, Calabrese LH, Leavitt RY, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088–93.

    Article  PubMed  Google Scholar 

  23. Mahr A, Guillevin L, Poissonnet M, et al. Prevalences of polyarteritis nodosa, microscopic polyantiitis, Wegener’s granulomatosis, and Churg–Strauss syndrome in a French urban multiethnic population in 2000: a capture–recapture estimate. Arthritis Rheum 2004;51:92–9.

    Article  PubMed  Google Scholar 

  24. Moore PM. Neurologic manifestations of vasculitis: Update on immunolopathogenic mechanisms and clinical features. Ann Neurol 1995;37(1):S131–41.

    Article  PubMed  Google Scholar 

  25. Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis 2006;65:936–41.

    Article  PubMed  CAS  Google Scholar 

  26. Sato O, Conn DL. Polyarteritis and microscopic polyangitiis. In: Klippel JH, Dieppe PA, editors. Rheumatology. St. Louis: Mosby; 2003.

    Google Scholar 

  27. Savage CO, Cooke SP. The role of the endothelium in systemic vasculitis. J Autoimmun 1993 Apr;6(2):237-49.

  28. Schmidt WA. Use of imaging studies in the diagnosis of vascultitis. Curr Rheumatol Rep 2004;6:203–11.

    Article  PubMed  Google Scholar 

  29. Segelmark M, Selga D. The challenge of managing patients with polyarteritis nodosa. Curr Opin Rheumatol 2007;19:33–8.

    Article  PubMed  Google Scholar 

  30. Selga D, Mohammand A, Sturfelt G, et al. Polyarteritis nodosa when applying the Chapel Hill nomenclature—a descriptive study on ten patients. Rheumatology 2006;45:1276–81.

    Article  PubMed  CAS  Google Scholar 

  31. Stockigt JR, Topliss DJ, Hewett MJ. High-renin hypertension in necrotizing vasculitis. N Engl J Med 1979;300:1218.

    PubMed  CAS  Google Scholar 

  32. Tanaka N, Naoe S, Kawasaki T. Pathological study on autopsy cases of mucocutaneous lymph node syndrome. J Jap Red Cross Cent Hosp 1971;2:85–94.

    Google Scholar 

  33. Teichman JM, Mattrey RF, Demby AM, et al. Polyarteritis nodosa presenting as acute orchiditis: A case report and review of the literature. J Urol 1993;149:1139–40.

    PubMed  CAS  Google Scholar 

  34. Tervaert JW, Kallenberg C. Neurologic manifestations of systemic vasculities. Rheum Dis Clin North Am 1993;19:913–40.

    PubMed  CAS  Google Scholar 

  35. Trepo C, Guillevin L. Polyarteritis nodosa and extrahepatic manifestations of HBV infection: the case against autoimmune intervention in pathogenesis. J Autoimmun 2001 May;16(3):269-74.

    Google Scholar 

  36. Watts RA, Lane SE, Scott DG, et al. Epidemiology of vasculitis in Europe. Ann Rheum Dis 2001;60:1156–7.

    Article  PubMed  CAS  Google Scholar 

  37. Watts R, Lane S, Hansilk T, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 2007;66:222–7.

    Article  PubMed  Google Scholar 

  38. Zizic TM, Classen JN, Stevens MB, et al. Acute abdominal complications of systemic lupus erythematosus and polyarteritis nodosa. Am J Med 1982;73:525–31.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    H. David Pettigrew

  2. Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California at Davis, Davis, CA, USA

    Suzanne S. Teuber & M. Eric Gershwin

Authors
  1. H. David Pettigrew
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  2. Suzanne S. Teuber
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  3. M. Eric Gershwin
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Correspondence to M. Eric Gershwin.

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Pettigrew, H.D., Teuber, S.S. & Gershwin, M.E. Polyarteritis Nodosa. Compr Ther 33, 144–149 (2007). https://doi.org/10.1007/s12019-007-0012-2

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  • DOI: https://doi.org/10.1007/s12019-007-0012-2

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