Polyarteritis Nodosa

.■Systemic necrotizing inflammation of medium-sized and small muscular arteries: More common in adult males


■Spares the arterioles, capillaries, venules and glomeruli

■Associated with hepatitis B antigenemia

■Signs and symptoms

Abdominal painSystemic hypertensionAnorexia and weight lossAbdominal distentionHematemesis, melenaJaundicePainless hematuriaPeripheral neuropathyTender subcutaneous nodulesGangrene of fingers and toes

■Kidney (most frequently affected): 85%

Multiple intrarenal aneurysms Multiple aneurysms of renal vessels in Polyarteritis-Aneurysms may thrombose and disappear-Appear in new locations-Multiple small cortical infarcts-Angiographic findings1.1-5 mm saccular aneurysms of small and medium-sized arteries in 60-75% of cases

2.Secondary to necrosis of internal elastic lamina

3.Luminal irregularities and stenoses

4.Arterial occlusions and small tissue infarcts

■Lung (70% of cases)

Findings are variable and rarely characteristic enough to allow diagnosisMost characteristic pattern is fleeting, patchy consolidation identical to Loeffler'sPericardial effusionPleural effusionDiscoid atelectasisNodules which may cavitatePatchy consolidation

■Liver: affected 66% of cases

■Treatment : Corticosteroids (50% 5 year survival)