[Polyarteritis nodosa: differential diagnostics and therapy]

Area of Science:

• Rheumatology
• Immunology
• Infectious Diseases

Context:

• Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries.
• It can impact multiple organs, leading to diverse clinical presentations.

Purpose:

• To summarize the key aspects of Polyarteritis nodosa (PAN), including its manifestations, associations, and therapeutic strategies.
• To highlight the diagnostic challenges in differentiating PAN from other vasculitides.

Summary:

• PAN commonly affects the skin, peripheral nerves (mononeuritis multiplex), and renal/mesenteric vasculature, causing stenoses and aneurysms.
• Approximately one-third of PAN cases are associated with the hepatitis B virus (HBV).
• Treatment varies: immunosuppressants for primary PAN, and antiviral therapy plus plasmapheresis for HBV-related PAN.

Impact:

• Understanding PAN's varied presentation and specific treatment protocols is crucial for effective patient management.
• Accurate diagnosis, though complex, is essential to guide appropriate therapy and improve patient outcomes.