Polyarteritis nodosa (PAN) is a blood vessel disease characterized by inflammation of small and medium-sized arteries (vasculitis), preventing them from bringing oxygen and food to organs. Most cases occur in the 4th or 5th decade of life, although it can occur at any age. PAN most commonly affects vessels related to the skin, joints, peripheral nerves, gastrointestinal tract, heart, eyes, and kidneys. Symptoms are caused by damage to affected organs and may include fever, fatigue, weakness, loss of appetite, weight loss, muscle and joint aches, rashes, numbness, and abdominal pain. The underlying cause of PAN is unknown. Treatment involves medicines to suppress inflammation and the immune system, including steroids.

Hepatitis B virus (HBV), hepatitis C, and hairy cell leukemia have been associated with some cases of PAN. In one report from France, HBV accounted for a third of the cases of PAN. HBV-related PAN typically occurs within four months after the onset of HBV infection. PAN has also been seen in drug abusers (particularly those using amphetamines). It has also appeared to occur as an allergic reaction to some drugs and vaccines.

The specific symptoms of PAN are due to ischemia or infarction of tissues and organs. Thickening of the walls of affected vessels causes narrowing of the inside of the vessels, reducing blood flow and predisposing to blood clots in affected vessels.

In some cases, symptoms may depend on the exact location of the affected part of the GI tract. For example, vasculitis affecting the liver or gallbladder may cause right upper quadrant pain.

More serious complications of PAN involving the GI tract are rare but include bowel infarction (obstruction of blood) and perforation, cholecystitis, hepatic infarction, or pancreatic infarction.

When the cause of PAN is unknown (idiopathic), treatment involves corticosteroids and immunosuppressive medications. If there are no serious neurologic, renal, gastrointestinal, or heart symptoms, corticosteroids may initially be sufficient. For severe disease with these symptoms, cyclophosphamide may also be used. Hypertension should be treated aggressively.

When PAN is related to hepatitis B, treatment often involves steroids, anti-viral medications and sometimes plasma exchange (also called plasmapheresis).

It is always helpful to maintain a healthy diet and lifestyle; however, we are not aware of any alternative therapies or supplements of particular benefit for treatment of polyarteritis nodosa. We recommend that you talk with your healthcare provider further regarding your treatment options.

We could not find a description of the average life expectancy for individuals with polyarteritis nodosa. However, one study examined the overall mortality of a group of individuals with this condition. Mortality is a measure of the proportion of individuals in a group who die in a given time period. Of 348 individual with polyarteritis nodosa, approximately 20% had died within 5 years of initial diagnosis and treatment; approximately 32% had died within 10 years. Only a third of these deaths was directly caused by severe symptoms of polyarteritis nodosa. Factors which increased the risk of death included being older than 65 years, being recently diagnosed with high blood pressure (hypertension), or having gastrointestinal symptoms that required surgery at the time of diagnosis (for example, abdominal pain, internal bleeding, pancreatitis, cholecystitis, appendicitis).

PAN affects men more frequently than women. While it has been diagnosed in people of every age, it predominantly occurs in people between the ages of 45-65 years.