(PAN; Periarteritis Nodosa)
Polyarteritis nodosa (PAN) is a blood vessel disease. Medium sized arteries become inflamed. Sometimes, smaller arteries are involved. This leads to problems with the organs. Without treatment, PAN can lead to death.
The immune system attacks healthy arteries and causes swelling. Why the immune system does this is not known. For some people the immune system may be triggered by illnesses such as tuberculosis or hepatitis B or C.
PAN is more common in people 50 to 70 years of age, but it can happen at any age.
Other things that may raise the risk are:
PAN affects the whole body at the same time. A person may have:
- Weight loss
- Joint and muscle pain
- Rashes or small bumps under the skin
- Open sores
- Death of skin tissue
- Nervous system:
- Tingling, burning, pain, or numbness in the feet, hands, legs, arms, and face
- Problems thinking
- Belly pain
- Nausea and vomiting
- Diarrhea—may be with blood
- Vision problems
- Genital sores
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The doctor will ask about symptoms and health history. A physical exam will be done. There is no specific test for PAN. Tests may include:
- Blood tests
- Urine tests
- Biopsy of the affected area
- An arteriogram to check blood vessels
- A nerve conduction study to test muscles and nerves
Diagnosis is based on symptoms and test results.
The goal of treatment is to reduce swelling in the arteries. Finding and treating PAN early may help a person avoid problems it can cause.
Medicines may be given to:
- Ease swelling in the arteries
- Change how the immune system works
- Help manage infections
PAN cannot be prevented.
- de Boysson H. and Guillevin, L. Polyarteritis nodosa neurologic manifestations. Neurol Clin, 2019; 37(2): 345-357.
- Polyarteritis nodosa. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/polyarteritis-nodosa.
- Polyarteritis nodosa. The Johns Hopkins Vasculitis Center website. Available at: https://www.hopkinsvasculitis.org/types-vasculitis/polyarteritis-nodosa.
- Michael J. Fucci, DO, FACC
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