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Polyarteritis nodosa - Immunocompromised, HIV and AIDS
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Polyarteritis nodosa - Immunocompromised, HIV and AIDS

See also in: Skin
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Contributors: Belinda Tan MD, PhD, Marvin Turck MD
Other Resources UpToDate PubMed

Synopsis

Polyarteritis nodosa (PAN) refers to a necrotizing vasculitis of small- and medium-size arteries. The exact etiology is unknown, but it likely involves immune complex deposition, autoantibodies, inflammatory mediators, and adhesion molecules. Any organ may be affected, but PAN most commonly involves the skin, peripheral nerves, kidneys, joints and GI tract. Symptoms may include malaise, fever (in 50%), weakness, myalgias, arthralgias, abdominal pain, cutaneous ulcers, livedo reticularis, testicular pain, and weight loss. Renal involvement is common, manifested by proteinuria, hypertension, and urinary sediment abnormalities. Cardiac involvement presenting with myocardial infarction has been described. Peripheral neuropathy can result in motor and sensory deficits and may be a presenting symptom. Other complications include stroke, gangrene, renal failure, bowel perforation, GI bleeding, retinal detachment, and death. Corticosteroids and immunosuppressive drugs are the cornerstones of treatment.

Polyarteritis nodosa has been associated with infection with hepatitis B (30% of patients are positive for the B antigen), hepatitis C, HIV, CMV, parvovirus B19, HTLV, and streptococci. There appears to be an association with inflammatory bowel disease. An isolated cutaneous form also exists (benign cutaneous polyarteritis); it is more common in children. However, polyarteritis nodosa usually affects individuals in mid to late adulthood. It is slightly more common in men, and there is no apparent racial predilection.

Codes

ICD10CM:
M30.0 – Polyarteritis nodosa

SNOMEDCT:
155441006 – Polyarteritis nodosa

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 10/26/2017
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Polyarteritis nodosa - Immunocompromised, HIV and AIDS
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Polyarteritis nodosa : Abdominal pain, Fever, LDH elevated, Malaise, Neuropathy peripheral, Palpable purpura, Proteinuria, Vision loss, Arthralgia, Myalgia, CRP elevated, ESR elevated, RBC decreased
Clinical image of Polyarteritis nodosa
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