Inflammatory vasculitis in small and medium-sized arteries occur mainly at bifurcations and branch points. Aneurysms develop in the weakened vessel, carrying a subsequent risk for rupture and hemorrhage

Nodosa’ are small aneurysms produced by fibrotic healing.

The cause is unknown, but viral infections such as HIV, CMV, HBV are associated with Polyarteritis Nodosa.

Raised BP, fever, livedo reticularis, mononeuritis multiplex 

Fever, malaise, anorexia and weight loss, myalgia and arthralgia. 

It is an acute multisystem disease, which can affect: 

Cardiovascular: Pericarditis, myocardial infarction and congestive heart failure

Neurological: Seizures, motor, sensory, or mixed sensorimotor polyneuropathy

Gastrointestinal: Abdominal pain, nausea, vomiting, GI infarction

Eyes: Retinal vasculitis, retinal detachment.

Kidneys:  Renal failure

Skin: Rash, purpura, nodules, cutaneous infarcts, Raynaud phenomenon

Bloods: FBC, ESR, CRP, ANCA, viral serology, blood cultures

Urine Dip: To screen for infection

Imaging: Chest X-ray or Angiography looking for aneurysms and stenosis

EMG and NCS to assess for peripheral neuropathy

Medical: Corticosteroids, cyclophosphamide, anti-viral therapy for hepatitis-

related Polyarteritis Nodosa

Better in patients with cutaneous Polyarteritis Nodosa without systemic or visceral involvement