Polyarteritis Nodosa, (Updated) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

by Kenneth Kee

Overview

This book describes Polyarteritis Nodosa (updated), Diagnosis and Treatment and Related Diseases
Polyarteritis nodosa is a serious blood vessel disease in which small and medium-sized arteries become inflamed and damaged.
PAN was separated into 2 sub-types according to the size of vessel involved in adults:
1.Classical PAN - medium-sized vessels
2.Microscopic polyangiitis (MPA) - small vessels
A less severe form called cutaneous polyarteritis nodosa (CPAN) has also been reported
Causes
Polyarteritis nodosa is a disorder that involves arteries, the blood vessels that transport oxygen-rich blood to organs and tissues.
The cause is not known but it happens when certain immune cells attack the involved arteries.
More adults than children obtain this disease.
The tissues that are supplied by the involved arteries do not get the oxygen and nourishment they require, and become injured.
People with active hepatitis B and C may have this disorder.
Symptoms
Symptoms and signs are due to the inflammation and ischemia of the involved organs.
Any organ may be involved with the exception of the lungs.
Symptoms are produced by injury to involved organs, often the skin, heart, kidneys and nervous system.
1.Abdominal pain
2.Decreased appetite
3.Fatigue
4.Fever
5.Joint aches
6.Muscle aches
7.Unintentional weight loss
8.Weakness
9.Peripheral neuropathy
10.Damage to the nervous system may produce strokes or seizures.
11.Renal involvement may be in the glomeruli or renal vasculature
Diagnosis:
1.Histological evidence of vasculitis
2.Positive serology for ANCA
3.Specific investigations strongly indicative of vasculitis and granuloma-E.g. angiography or skin biopsy
4. Eosinophilia (≥10%)
Investigations
1.Hepatitis B surface antigen is positive in 30%.
2.The p-ANCA test is normally positive, but not pathognomonic.
3.ESR is increased or C-reactive protein (CRP).
4.FBC reveals leukocytosis with raised neutrophils.
5.Hypergammaglobulinemia happens in 30%.
6.Arteriography reveals microaneurysms in the small-sized and medium-sized arteries of the kidneys and abdominal viscera
7.Tissue biopsy
Complications
Without treatment, hypertension-induced glomerulonephritis is a source of great morbidity and mortality.
Treatment
If there is no presence of hepatitis and the symptoms are fairly mild, the doctor normally will start the treatment with a steroid drug, such as prednisone, a powerful medicine that suppresses the immune system and decreases inflammation.
If there is more severe symptoms affecting the heart, nerves or kidneys, if the patient does not improve with initial treatment or if the patient has relapses after initial treatment, prednisone may be combined with an adjunct immunosuppressant medication such as:
1.Cyclophosphamide (Cytoxan)
2.Azathioprine (Imuran),
3.Methotrexate (Rheumatrex),
4.Mycophenolate mofetil (Cellcept) or
5.Rituximab (Rituxan).
Full treatment normally requires at least one year.
If polyarteritis nodosa is linked to hepatitis B or hepatitis C, the patient may be treated with antiviral medicines alone to fight the liver infection.
Antiviral treatment may be added to prednisone to control arterial inflammation
Occasionally, this is accompanied by plasmapheresis
Plasmapheresis is a procedure in which plasma is separated from the blood, cleaned of abnormal antibodies and then returned to the blood.
Updated treatment:
1.Case reports have good response to treatment with tumor necrosis factor inhibitors, such as infliximab and etanercept.
2.The interleukin-6 antagonist tocilizumab has been given successfully in refractory cases.
3.Effective use of the anti-CD20 agent rituximab in an adult with refractory PAN has been done

TABLE OF CONTENT
Introduction
Chapter 1 Polyarteritis Nodosa
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Henoch Schonlein Purpura
Chapter 8 Giant Cell Arteritis
Epilogue

Product Details

BN ID:	2940156028337
Publisher:	Kenneth Kee
Publication date:	03/26/2019
Sold by:	Smashwords
Format:	eBook
File size:	177 KB

About the Author

Medical doctor since 1972. Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009. Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993. Dr Kenneth Kee is still working as a family doctor at the age of 65. However he has reduced his consultation hours to 3 hours in the morning and 2 hours in the afternoon. He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com. His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog afamilydoctorstale.blogspot.com. This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com. From which many free articles from the blog was taken and put together into 550 amazon kindle books and some into Smashwords.com eBooks. He apologized for typos and spelling mistakes in his earlier books. He will endeavor to improve the writing in futures. Some people have complained that the simple guides are too simple. For their information they are made simple in order to educate the patients. The later books go into more details of medical conditions. The first chapter of all my ebooks is always taken from my blog A Simple Guide to Medical Conditions which was started in 2007 as a simple educational help to my patients on my first blog http://kennethkee.blogspot.com. The medical condition was described simply and direct to the point. Because the simple guide as taken from the blog was described as too simple, I have increased the other chapters to include more detailed description of the illness, symptoms, diagnosis and treatment. As a result there are the complaints by some readers of constant repetitions of the same contents but in detail and fairly up to date. He has published 550 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter. The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks. He does not do any night duty since 2000 ever since Dr Tan had his second stroke. His clinic is now relocated to the Bouna Vista Community Centre. The 2 units of his original clinic are being demolished to make way for a new Shopping Mall. He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting with the Apple computer and going to PC. All the PC is upgraded by himself from XT to the present Pentium duo core. The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive. He is also into DIY changing his own toilet cistern and other electric appliance. His hunger for knowledge has not abated and he is a lifelong learner. The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned. This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale. Dr Kee is the author of: "A Family Doctor's Tale" "Life Lessons Learned From The Study And Practice Of Medicine" "Case Notes From A Family Doctor"