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The American College of Rheumatology (ACR) has established criteria that should be fulfilled if a patient is to be included in a research study of PAN. Aneurysms most often affect the arteries leading to the kidneys, liver or gastrointestinal tract. An angiogram of the abdominal blood vessels may also be very helpful in diagnosing PAN. Most biopsies are taken from skin, symptomatic nerve, or muscle. The diagnosis is confirmed by a biopsy showing pathologic changes in medium-sized arteries. (These nerves can then be biopsied to confirm the diagnosis). Nerve conduction studies are a non-invasive way of identifying nerves that are involved by the inflammation.

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If there is skin or muscle/nerve involvement, a skin or muscle/nerve biopsy can be extremely helpful in coming to a definite diagnosis of PAN. Proteinuria (protein in the urine) is common among those with kidney involvement. Most patients with PAN have elevated ESRs. Routine laboratory tests may provide important clues to PAN, but there is no single blood test that is diagnostic of this disease. It is possible that other infections contribute to other cases of PAN, but links between other infections and this disease remain conjectural at the present time. With the availability of hepatitis B vaccine now, cases of PAN caused by hepatitis B are now rare in the developed world. Hepatitis B causes a minority of cases of PAN.

Scleritis or inflammation in the sclera (white part of the eye).

However, some patients develop myocardial infarctions (heart attacks) or congestive heart failure.

Clinical involvement of the heart does not usually cause symptoms.

Hemorrhage, bowel infarction, and perforation are rare, but very serious.

Abdominal pain, gastrointestinal bleeding (occasionally is mistaken for inflammatory bowel disease).

Small percentage of patients go on to require dialysis.

Renal artery vasculitis may lead to protein in the urine, impaired kidney function, and hypertension.Skin involvement occurs most often on the legs and is very painful.Skin abnormalities are very common in PAN and may include purpura, livedo reticularis, ulcers, nodules or gangrene.Central nervous system (CNS) lesions may occur 2 to 3 years after the onset of PAN and may lead to cognitive dysfunction, decreased alertness, seizures and neurologic deficits.This includes tingling, numbness and/or pain in the hands, arms, feet, and legs. Peripheral neuropathies are very common (50 to 70%).However, the disease has a predilection for certain organs and tissues these are described below. The presentation of PAN may also include skin abnormalities (rash, ulcers) and peripheral neuropathy (pain, the sensations of burning, tingling, or numbness, or weakness in a hand or foot). Many patients with PAN have high blood pressure and elevated erythrocyte sedimentation rates (ESR). The disease can affect nearly any site in the body, but it has a predisposition for organs such as the skin, kidney, nerves, and gastrointestinal tract. Patients may have nonspecific complaints such as fever, malaise, weight loss, anorexia, and abdominal pain. PAN may develop in a subacute fashion, over several weeks or months. PAN is a multisystem disease that may present with fever, sweats, weight loss, and severe muscle and joint aches/pains. Classic symptoms and signs of Polyarteritis Nodosa In the rest of the cases, the cause(s) is presently unknown, and the disease is said to be вЂњidiopathicвЂќ in nature. A minority of patients with PAN have an active hepatitis B infection. Men are twice as likely to be affected than women. Most cases of PAN occur in the 4th or 5th decade, although it can occur at any age. Who gets Polyarteritis Nodosa (the вЂњtypicalвЂќ patient)? Polyarteritis nodosa is sometimes termed вЂњsystemic necrotizing vasculitisвЂќ, but this term is non-specific as other forms of vasculitis also have systemic and necrotizing features. The name was changed to polyarteritis nodosa (PAN) to underscore the fact that inflammation throughout the entire arterial wall вЂ“ not just around the wall вЂ“ is a major disease feature. They termed this disorder вЂњperiarteritis nodosaвЂќ because of the inflammation they observed around the blood vessel wall. The first description of this disease dates back to 1866 when Kussmaul and Maier identified a condition that consisted of вЂњfocal, inflammatory, arterial nodulesвЂќ. In medical terms, by David Hellmann, M.D.Treatment and Course of Polyarteritis Nodosa.Classic symptoms of Polyarteritis Nodosa.Who gets Polyarteritis Nodosa (the вЂњtypicalвЂќ patients)?.