This website is under continuing development and improvements and the official launch will be at the end of 2018. Lots of Comments, ideas and feedback vital and always welcome at drokane at gmail.com. You must agree to the legal advice below before using this web resource

Polyarteritis Nodosa


  • This a systemic necrotising vasculitis of medium-sized arteries without the involvement of smaller vessels.
  • It may be associated with hepatitis virus infection.
  • Only about 20% have any cerebral involvement.


  • Patients have typical systemic illness, myalgia, weight loss, fever, arthritis
  • Peripheral ischaemic changes. They can have a polyneuropathy.
  • Ischaemic and haemorrhagic strokes as well as an encephalopathy.


PAN may be diagnosed with three of these ten criteria (82% sensitivity, 86% specificity), if other vasculitides are excluded
1 Loss of weight >4 kg
2 Livedo reticularis
3 Testicular pain
4 Myalgias
5 Mononeuritis or polyneuritis
6 Blood pressure elevation >90 mmHg
7 Creatinine >1,5 mg/dl
8 Hepatitis B or C virus antibodies
9 Pathologic arteriography (aneurysm, occlusions)
10 Typical histology finding


  • FBC, U&E, ESR, CRP, Vasculitis screen
  • Brain imaging CT/MRI/MRA
  • Biopsies classically show necrotising granulomatous inflammation.


  • Induction therapy is usually with Steroids and Cyclophosphamide.
  • Plasma exchange has been used.
  • If there is positive viral serology then appropriate antivirals against Hepatitis B or C may be given.


free web counter