Discussion of Polyarteritis nodosa
- Polyarteritis nodosa is a necrotizing vasculitis that mainly involves small and medium-sized arteries.
- Multiple aneurysm formation is a characteristic finding in polyarteritis nodosa (50%–60% of cases).
- The kidney is most commonly involved (80%–90% of cases), followed by the gastrointestinal tract (50%–70%), liver (50%–60%), spleen (45%), and pancreas (25%–35%).
- Specific complaints related to vascular involvement within a particular organ system include renal failure or hypertension in renal involvement; peripheral neuropathy in peripheral nervous system involvement; congestive heart failure, myocardial infarction, or pericarditis in cardiac involvement; and rash, purpura, or nodules in skin involvement.
- A definitive diagnosis may be made in certain clinical settings by performing tissue biopsy from a symptomatic organ site, but sampling errors and lack of disease specificity may be problematic.
- If left untreated, the disease is fatal in most instances in association with renal failure, gastrointestinal complications such as bowel infarction or perforation, or cardiovascular causes.
- Therapy with corticosteroids and cyclophosphamide results in remission or cure in 90% of affected patients.
 Imaging Findings for Polyarteritis nodosa
- The role of angiography is to help confirm or support the clinical impression when a suitable biopsy site is lacking or when the biopsy results are inconclusive.
- Angiographic findings include aneurysms, ectasia, or occlusive disease.
- Differential considerations include other types of vasculitis, such as rheumatoid vasculitis, systemic lupus erythematosus, and Churg-Strauss syndrome.
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 References for Polyarteritis nodosa
- Hyun K. Ha, Seung H. Lee, Sung E. Rha, Jee-H. Kim, Jae Y. Byun, Hyo K. Lim, Jin W. Chung, Jeong G. Kim, Pyo N. Kim, Moon-G. Lee, and Yong H. Auh. Radiologic Features of Vasculitis Involving the Gastrointestinal Tract. RadioGraphics 2000 20: 779-794.