The cause of PAN is not yet known. In some people there is a clear relationship between the pot and the hepatitis B virus infection though why this is the case is not entirely clear. Only a few people with hepatitis B infection never develop the PAN and only a handful of people with hepatitis B infection have PAN.
As with other types of vaskulitis there is no single diagnostic test. Enforcement of the diagnosis is based on symptoms described by the patient, physical examination, laboratory tests and possibly a biopsy of the affected area. Blood tests will show evidence of inflammation. The blood vessels in the abdomen is often influenced and angiography (x-rays of the blood vessels) can Show a typical findings that help with the diagnosis.
High-dose Steroid and siklofosfamid are often used to get the inflammation under control (the remission induction). Once under the control of the treatment often continue for 12 months with a low dose of medication and then can be stopped in some patients.
Siklofosfamid is usually used to treat severe forms of vaskulitis and also known as anti-cancer chemotherapy drugs. This is usually given as a daily tablet or intermittent injection every few weeks. Siklofosfamid has the potential to cause side effects including serious short-term irritation of the bladder (cystitis) and suppression of bone marrow (low white cell count) which leads to infection. Mesna (uroprotectant) are often given to patients who received injections of siklofosfamid to reduce the risk of bladder problems.
Patients may also be recommended to drink lots of water to flush the bladder but this should be discussed with your medical team. Short-term effects include nausea and vomiting, and hair loss. Siklofosfamid time over the long-term can lead to Infertility in both men and women. The man who might still want to have children should consider sperm banking.
Long term use of siklofosfamid is considered undesirable and has been associated with an increased risk of some cancers, such as cancer of the bladder. Steroids (Prednisolone, Methylprednisolone, cortisone, dexamethasone, prednison). A naturally occurring Steroid hormone in the body is produced by the adrenal glands and is important for normal health.
Artificial steroids used to treat inflammatory diseases and other vaskulitis and is very effective in reducing inflammation. They are often used initially at high doses to control the disease and then the dose will be reduced as quickly as possible to reduce the side effects. Unfortunately very common side effects with steroid medications.
Common side effects include an increased risk of serious and infections, diabetes and osteoporosis. Other common side effects include weight gain, disturbed sleep, mood swings (including rare depression and very rarely psychosis), muscle weakness, dyspepsia (indigestion) and heartburn, increased hair growth, fluid retention, increased blood pressure and thin skin.
The artificial steroid being taken when the adrenal glands can stop producing the body's own steroid so it is important that patients do not stop taking steroids suddenly and the rate of reduction should be monitored by a doctor. Stop steroid too quickly can result in a lack of steroids if the adrenal glands are not able to respond quickly and this can cause significant problems.
It is crucial that patients on high doses of steroids are monitored for the development of diabetes. If appropriate, patients may be prescribed Bisphosphonates, calcium or vitamin D to protect their bones. Patients may also be prescribed tablets to Protect the stomach from side effects (eg. Ranitidine, Omeprazole, Lansoprazole or similar).