Polyarteritis nodosa

An uncommon disease of medium-sized arteries, also called periarteritis nodosa. Areas of arterial wall become inflamed, weakened, and liable to aneurysms. The severity of the condition depends on the arteries that are affected and how much they are weakened. The cause seems to be an immune system disturbance, sometimes triggered by exposure to the hepatitis B virus. It is most common in adults and affects men more than women. Early symptoms of polyarteritis nodosa include fever, aching muscles and joints, general malaise, loss of appetite and weight, and, sometimes, nerve pain. There is also hypertension, skin ulceration, and gangrene. If the coronary arteries are affected, myocardial infarction may occur. Many patients suffer abdominal pain, nausea, vomiting, diarrhoea, and blood in the faeces. Diagnosis is made by biopsy and angiography. Large doses of corticosteroids, and in some cases immunosuppressants, may allow survival for at least 5 years. Without treatment, few patients survive for this length of time.


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