23- M CELL VASCULITIS (main visceral vessels:renal,coronary)

• Polyarteritis nodosa (PAN)


  A condition characterized by inflammation and damage to small and medium-sized blood vessels
• Polyarteritis nodosa (PAN)


  • Predominantly affects middle-aged men
  • Associated with chronic hepatitis B and C (especially hepatitis B)
  • Due to immune complex deposition and necrotizing arteritis associated with microaneurysms, thrombosis, and infarction
  • Spares the lungs
• Neurological


  • Foot drop
  • Mononeuritis multiplex
  • Stroke in the young
• Skin


  • Digital and lower limb ulcers
  • Livedo reticularis
  • Purpura
• GI


  • GI bleed
  • Abdominal pain worse with food
  • Nausea & Vomiting
• Renal


  • Glomerulonephritis
  • Hypertension
• Diagnosis


  • Angiography (microaneurysms [beading] in hepatic, intestinal, renal vessels)
  • Biopsy of an affected organ, often the kidney
  • High ESR/CRP, P-ANCA in 20%
  • Screen all for Hep B and C
• Treatment


  1. Prednisone

  2. Immunosuppressive drugs (cyclophosphamide)
• 2.! Kawasaki disease (affects children <5 years)