[Diagnosis and clinical course of periarteritis nodosa]

The clinical symptoms, diagnostic procedure and course under treatment in 10 patients with polyarteritis nodosa are studied retrospectively. Clinically, 3 patients showed peripheral arterial occlusive disease in the lower extremities. 3 patients had evidence of preceding acute type B hepatitis. The diagnosis was confirmed by biopsy in 7 cases, by selective arteriography of the kidneys showing multiple small aneurysms in one case; in 2 patients the diagnosis was based upon the clinical findings only. Complete remission was achieved in 7 of 10 treated patients, in 5 patients with corticosteroids alone and in 2 patients with a combination of corticosteroids and cytotoxic agents. 4 patients died, one of them from vasculitis and 3 from other causes. 5-year survival for all patients was 52%. The diagnostic value of arteriography, the clinical picture of polyarteritis nodosa with peripheral arterial occlusive disease, and the association between hepatitis B infection and polyarteritis nodosa are discussed.