Polyarteritis Nodosa is a multisystem disease that may present with fever, sweating, weight loss, and severe muscle and joint pain. Can develop in subakut mode, for a few weeks or months. The patient may have specific complaints such as fever, malaise, weight loss, anorexia and abdominal pain.
The disease can affect nearly any site in the body, but have a tendency to organs such as the skin, kidneys, nerves, and the digestive tract. Many patients with high blood pressure and elevated levels of sedimentation of erythrocytes. The presentation can also include abnormalities of the skin rashes, ulcers and peripheral neuropathy pain, sensation of burning, tingling, or numbness or weakness in the hands or feet.
Skin abnormalities are extremely common in the pot and may include purpura, livedo reticularis, ulcers, nodules or gangrene. Involvement of the skin occurs most often on the legs and is very painful.
Nerve conduction studies is a non-invasive way to identify the nerves involved with inflammation. (This nerve can then be biopsied breast for confirming a diagnosis). The Diagnosis is confirmed by biopsy shows pathological changes in the arteries. The biopsy site may vary. Most biopsies taken from skin, muscle or nerve symptoms.
Arteritis Polyarteritis nodosa is a small – and medium – sized that affects many organs, especially the skin, peripheral nerves, intestines, kidneys, and liver. Age of onset ranged from infancy to late adulthood, but the 40-year average. Polyarteritis nodosa associated with active hepatitis B, hepatitis C, or both; Therefore, the disease is more common in injection drug users.
Polyarteritis nodosa may be mediated by deposition of immune complexes. The evidence includes the observation that a patient with polyarteritis nodosa associated with hepatitis B or hepatitis C have immune complexes consisting of viral antigens and antibodies that circulate in the blood and stored in the inflamed veins. In addition, antiviral therapy can send vaskulitis in some patients.
Gradual Onset over the past weeks to months, and early symptoms often specific. The initial instructions that the patient has vaskulitis usually come from the skin or peripheral nervous system in which the myocardial one mixed motor and sensory nerve after another mononeuritis results in multiplek, one of the most specific instructions that the patient has vaskulitis.
Kidney involvement eventually develops in most and is accompanied with hypertension patients, while half of Wegener's granulomatosis rarely raised blood pressure. Polyarteritis nodosa is also often involves stomach intestinal angina, bleeding, perforation, heart myocarditis, myocardial infarction or scleritis. An outbreak of kidney or mesenterika micoaneurysms can simulate acute abdomen.
Confirming the diagnosis requires biopsy specimens that display either small-or medium-sized arteries, or mesenterika Arteriography showing microaneurysms or alternating areas of stenosis and widening.
Biopsy of nerve symptoms or symptoms of muscle was sensitive, whereas 70% of asymptomatic biopsy is less than 25% sensitive. Because mesenterika Angiography is 60% sensitive, it must be done when there are no bergejala site for biopsy. Renal Biopsy should be avoided unless it rules out angiography microaneurysms are prone to rupture.
However, the new study shows that alone can achieve high prednison survival just as prednison and siklofosfamid, though less frequent flares on patients taking siklofosfamid. Other studies show that traditional therapy with prednison and siklofosfamid should be abandoned on patient with polyarteritis nodosa associated with hepatitis b.
A new propsed regimen consists of 2 weeks of prednison for controlling vaskulitis, followed by Plasmaperesis to remove the immune complexes, and accompanied by antiviral therapy with lamivudine for hepatitis B infections patients get rid of the. value of long term Saving anti viral therapy for polyarteritis nodosa associated with hepatitis C are not established.