Standard and Interpretation
Recommendations of diagnosis and treatment of polyarteritis nodosa
Mansur Mihray, Da Zhanyun, Guo Jiangtao, Wu Lijun, Zhao Yan, on behalf of Chinese Rheumatology Association
Published 2022-07-01
Cite as Chin J Intern Med, 2022, 61(7): 749-755. DOI: 10.3760/cma.j.cn112138-20211201-00852
Abstract
Polyarteritis nodosa (PAN) is a rare vasculitis that mainly involves small and medium arteries. It often occurs at the points where the vessels bifurcate, leading to microaneurysm formation, thrombosis, aneurysm rupture and bleeding, and infarction of organs.About a third of cases are associated with hepatitis B virus (HBV) infection.All tissues and organs of the body can be affected, with skin, joints and peripheral nerves being the most common.The pathological changes were fibrinoid necrosis, inflammatory cell infiltration and luminal thrombosis in the acute stage, and fibrous hyperplasia in the chronic stage.Overall outcomes for the disease have improved in recent decades, mainly reflecting early diagnosis and more effective treatments.The main treatments for PAN are glucocorticoid and cyclophosphamide.Patients with HBV-associated PAN should receive antiviral therapy and plasma exchange.
Key words:
Polyarteritis nodosa; Diagnosis; Treatment
Contributor Information
Mansur Mihray
Department of Rheumatology and Clinical Immunology, People′s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Rheumatoid Arthritis, Urumuqi 830001, China
Da Zhanyun
Department of Rheumatology and Immunology, Affiliated Hospital of Nantong University, Nantong 220001, China
Guo Jiangtao
Department of Rheumatology and Clinical Immunology, People′s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
Wu Lijun
Department of Rheumatology and Clinical Immunology, People′s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Rheumatoid Arthritis, Urumuqi 830001, China
Zhao Yan
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science &
Technology, State Key Laboratory of Complex Severe and Rare Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China
on behalf of Chinese Rheumatology Association
