Polyarteritis nodosa natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
* | * Common complications of PAN include: | ||
** [[Stroke]] | ** [[Stroke]] | ||
** [[Kidney failure]] | ** [[Kidney failure]] | ||
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==Prognosis== | ==Prognosis== | ||
* Prognosis is generally good if the treatment is started. | |||
* Therapy results in remissions or cures in 90% of cases. | * Therapy results in remissions or cures in 90% of cases. | ||
* Current treatments using [[steroids]] and other drugs that suppress the [[immune system]] (such as [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival. | * Current treatments using [[steroids]] and other drugs that suppress the [[immune system]] (such as [[cyclophosphamide]]) can improve symptoms and the chance of long-term survival.<ref name="pmid42314">{{cite journal |vauthors=Leib ES, Restivo C, Paulus HE |title=Immunosuppressive and corticosteroid therapy of polyarteritis nodosa |journal=Am. J. Med. |volume=67 |issue=6 |pages=941–7 |date=December 1979 |pmid=42314 |doi= |url=}}</ref> | ||
* Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another [[Immunosuppressive therapy|immunosuppressive]] drug in addition to [[prednisone]]. | * Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another [[Immunosuppressive therapy|immunosuppressive]] drug in addition to [[prednisone]].<ref name="pmid8569467">{{cite journal |vauthors=Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O, Thibult N, Casassus P |title=Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients |journal=Medicine (Baltimore) |volume=75 |issue=1 |pages=17–28 |date=January 1996 |pmid=8569467 |doi= |url=}}</ref> | ||
# [[Proteinuria]] >1g/day | # [[Proteinuria]] >1g/day | ||
#[[Azotemia]] | #[[Azotemia]] |
Revision as of 22:38, 15 May 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.
Overview
Natural History
- Untreated, the disease is fatal in most cases.
- The most serious associated conditions generally involve the kidneys and gastrointestinal tract.
- Without treatment, the outlook is poor.
Complications
- Common complications of PAN include:
Prognosis
- Prognosis is generally good if the treatment is started.
- Therapy results in remissions or cures in 90% of cases.
- Current treatments using steroids and other drugs that suppress the immune system (such as cyclophosphamide) can improve symptoms and the chance of long-term survival.[1]
- Guillevin and coworkers have described five prognostic factors that predict high probability of mortality and are considered indications for another immunosuppressive drug in addition to prednisone.[2]
- Proteinuria >1g/day
- Azotemia
- Cardiomyopathy
- Gastrointestinal involvement
- Central nervous system disease With none of these factors, 5-year mortality is 12%. With 2 or more 5-year mortality is 46%[3]
References
- ↑ Leib ES, Restivo C, Paulus HE (December 1979). "Immunosuppressive and corticosteroid therapy of polyarteritis nodosa". Am. J. Med. 67 (6): 941–7. PMID 42314.
- ↑ Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O, Thibult N, Casassus P (January 1996). "Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients". Medicine (Baltimore). 75 (1): 17–28. PMID 8569467.
- ↑ Kelley's Textbook of Rheumatology,8th edition