Polyarteritis nodosa causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3] Cafer Zorkun, M.D., Ph.D. [4]; Haritha Machavarapu, M.B.B.S.
Overview
Causes
Common Causes
PAN may be caused by:
- Idiopathic
- Hepatitis B infection[1] [2]
- Hepatitis C infection.[3]
- hairy cell leukemia.[4]
Other disease associations
Controversy has surrounded the potential association of hepatitis C virus (HCV) with PAN. HCV may be linked to cutaneous PAN, a benign, limited form of PAN. In a study of 16 patients with cutaneous PAN, 5 tested positive for hepatitis C. null 17 HCV-associated PAN has also been described in 31 patients included in a larger 161 patient cohort with HCV-related vasculitis in France. null 18 Despite the presence of serum cryoglobulins, these patients were diagnosed with HCV-PAN on the basis of typical histopathologic features of PAN and/or the presence of microaneurysms and/or multiple stenoses on abdominal and/or renal angiography.
A number of other infectious organisms have been reported in association with PAN or PAN-like diseases, but causal evidence is inconsistent. These organisms include varicella-zoster virus, parvovirus B-19, cytomegalovirus, human T-cell leukemia virus, streptococcal species, Klebsiella species, Pseudomonas species, Yersinia species, Toxoplasma gondii, Rickettsiae, trichinosis, and sarcosporidiosis.[[null 19], [null 20]] Recently, reports of associations with PAN and human immunodeficiency virus null 21 and cutaneous PAN and tuberculosis null 22 have been published as well.
Some syndromes, including rheumatic diseases, malignancies, and infections have been associated with clinical syndromes indistinguishable from idiopathic PAN. Rheumatoid arthritis (RA) and Sjögren syndrome have been associated with PAN. Notably, the incidence of RA-associated vasculitis has decreased greatly since the 1980s, likely attributable to improvements in the management of RA. null 23 Cutaneous PAN occurring with HLA-B39 spondyloarthritis, null 24 common variable immunodeficiency, null 25 and psoriatic arthritis in an 11-year-old boy null 26 have also been reported.
Hematologic malignancies, such as hairy cell leukemia and, in one case, angioimmunoblastic T cell lymphoma, have been associated with PAN-like vasculitides. [[null 27], [null 28]]
Causes
Common Causes
The primary cause of PAN is idiopathic, but secondary causes include hepatitis B virus infection , hepatitis C virus infection, and hairy cell leukemia . Polyarteritis nodosa is a disease of unknown cause that affects arteries, the blood vessels that carry oxygenated blood to organs and tissues. It occurs when certain immune cells attack the affected arteries. More adults than children get this disease. It damages the tissues supplied by the affected arteries because the tissues are not receiving the oxygen and nourishment they need. People with active Hepatitis B and Hepatitis C may develop this disease.
Drug Side Effect
References
- ↑ Stone JH (October 2002). "Polyarteritis nodosa". JAMA. 288 (13): 1632–9. PMID 12350194.
- ↑ Guillevin L, Mahr A, Callard P, Godmer P, Pagnoux C, Leray E; et al. (2005). "Hepatitis B virus-associated polyarteritis nodosa: clinical characteristics, outcome, and impact of treatment in 115 patients". Medicine (Baltimore). 84 (5): 313–22. PMID 16148731.
- ↑ Ramos-Casals M, Muñoz S, Medina F, Jara LJ, Rosas J, Calvo-Alen J; et al. (2009). "Systemic autoimmune diseases in patients with hepatitis C virus infection: characterization of 1020 cases (The HISPAMEC Registry)". J Rheumatol. 36 (7): 1442–8. doi:10.3899/jrheum.080874. PMID 19369460.
- ↑ Hasler P, Kistler H, Gerber H (1995). "Vasculitides in hairy cell leukemia". Semin Arthritis Rheum. 25 (2): 134–42. PMID 8578313.