Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
I have been diagnosed with polyarteritis nodosa (PAN). How does PAN differ from lupus?
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Jay W. Marks, MD
Polyarteritis nodosa is a type of inflammation of the blood vessels (vasculitis) that affects medium- and large-sized arteries. Depending on which blood vessels are involved and specifically the tissues they supply, injury can occur to internal organs, such as the kidneys or bowel.
Polyarteritis nodosa is an autoimmune disease that affects
arteries.
Common areas affected include the muscles, joints,
intestines (bowels), nerves, kidneys, and skin.
Diagnosis of polyarteritis nodosa is confirmed by a biopsy
of involved tissue or angiography.
Treatment is directed toward decreasing the inflammation of
the arteries.
What is polyarteritis nodosa?
Polyarteritis nodosa is a rare autoimmune disease featuring spontaneous inflammation of the arteries (arteritis, a form of blood vessel inflammation or "vasculitis"). Autoimmune diseases are characterized by an overactive, misdirected immune system that attacks one's own body. Because arteries are involved, the disease can affect any organ of the body. The most common areas of involvement include the muscles, joints, intestines (bowels), nerves, kidneys, and skin. Poor function or pain in any of these organs can be a symptom. Poor blood supply to the bowels can cause abdominal pain, local bowel death, and bleeding. Fatigue, weight loss, and fever are common. Polyarteritis nodosa is often abbreviated PAN.
What are causes and risk factors for polyarteritis nodosa?
Polyarteritis nodosa is most common in
middle-age people. Its cause is unknown, but it has been reported after
hepatitis B infection. Polyarteritis is not felt to be an inherited condition.
What are symptoms and signs of polyarteritis nodosa?
Polyarteritis nodosa causes symptoms and signs that are a result of injury to the blood vessels. Therefore, the symptoms and signs depend on which vessels are affected and to what degree. This can lead to organ damage or injury. For example, if blood vessels supplying the nerves or muscles are affected, the nerves or muscles can be damaged. If the blood vessels to the kidneys are affected, kidney damage with blood in the urine can result. Symptoms and signs can include fatigue, weight loss, high blood pressure, muscle pain (myalgia), joint pain (arthralgia), testicular pain, livido reticularis, nerve damage, and abdominal pain.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Connective tissue disease is when the body's connective tissues come under attack, possibly becoming injured by inflammation. Inherited connective tissue diseases include Marfan syndrome and Ehlers-Danlos syndrome. Systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymositis, and dermatomyositis are examples of connective tissue diseases that have no known cause.
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependant on the type of hepatitis.
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of inflammation of the cartilage of various tissues of the body. Tissues containing cartilage that can become inflamed include the ears, nose, joints, spine, and windpipe (trachea). Tissues that have a biochemical makeup similar to that of cartilage such as the eyes, heart, and blood vessels, can also be affected. Nonsteroidal antiinflammatory medications (NSAIDs) is used as treatment for mild cases of the disease. Steroid-related medications also are usually required.
Scleritis is inflammation of the white part of the eye. It may be caused by a serious underlying condition, such as an autoimmune disease. Symptoms include redness, pain, tearing, sensitivity to light, and decreased visual acuity. Treatment may include eye drops as well as treatment for any underlying disease process. Scleritis cannot be prevented.
Vasculitis is a general term for a group of uncommon diseases that
feature inflammation of the
blood vessels. The blood vessels of the
body are referred to as the vascular system. The
blood vessels are comprised of arteries that pass oxygen-rich blood to the
tissues of the body and veins that return oxygen-depleted blood from the
tissues to the lungs for oxygen. Vasculitis is characterized by
inflammation in and damage to the walls of various blood vessels.
Each of the vasculitis diseases is defined by certain patterns of distribution of
blood vessel involvement, particular organ involvement, and laboratory test abnormalities.
As a group, these diseases are referred to as vasculitides.
The word vasculitis is derived from the Latin
"vasculum", vessel + "- itis", inflammation. Another term for vasculitis is
angiitis. When arteries are the inflamed blood vessels, the condition is also referred to as arteritis. When the veins are ...