What Is Polyarteritis Nodosa (PAN)?
Polyarteritis nodosa (PAN) is a condition that causes swollen arteries. It primarily affects small and medium-sized arteries, which can become inflamed or damaged. This is a serious disease of the blood vessels caused by an immune system malfunction.
Ongoing treatment is crucial for survival, and there is a risk of serious complications for patients who don’t seek medical care.
Causes of PAN
If you have PAN, the arteries that carry blood to your tissues and organs are damaged. When organs don’t receive enough oxygen-rich blood, they stop working the way they should. This type of arterial damage occurs when your immune system attacks your arteries. Since there is no one identifiable cause of this immune reaction, the exact cause of PAN remains unknown.
Risk Factors for PAN
While the exact cause of PAN is unknown, there are many factors that can increase your risk of developing the disease. PAN is more common in patients:
- 40 to 50 years of age or older
- who are male
- with an active hepatitis B or C infection
It is important to understand these risk factors and talk to your doctor about receiving regular tests. This is especially true if you experience symptoms of PAN or if the condition runs in your family.
Symptoms of PAN
This condition ultimately affects all of your organs, including the skin. Your central nervous system may also be affected.
Symptoms of PAN are quite pronounced, and may include:
- decreased appetite
- sudden weight loss
- abdominal pain
- excessive fatigue
- muscle and joint aches
According to Johns Hopkins Medicine, PAN affects the nervous systems of up to 70 percent of patients. Without medical treatment, PAN can cause seizures and neurological issues, including reduced alertness and cognitive dysfunction, after two to three years (Johns Hopkins Medicine).
Skin lesions are also very common. PAN most often affects the skin on the legs, and the sores can be painful.
PAN is a complicated disease that requires multiple tests before a proper diagnosis can be made. Your doctor will likely order a complete blood count to measure the number of red and white blood cells you have.
You may also undergo:
- tissue biopsies: a small sample of an affected artery is taken for laboratory examination
- an arteriogram (X-ray of the arteries)
- erythrocyte sedimentation rate (ESR) test to measure inflammation
Once these tests are complete, your doctor will formulate a diagnosis and treatment plan.
In some cases, abdominal pain and gastrointestinal side effects are mistaken for inflammatory bowel disease. For this reason, it is important to report any long-term gastrointestinal effects to your doctor right away.
PAN is most commonly treated with a combination of prescription drugs, including:
- immune suppressants
- antiviral medications
High doses of corticosteroids, or steroids, are used to control symptoms of PAN by reducing inflammation and replacing certain hormones in the body. It should be noted that corticosteroids can cause a number of side effects, especially when taken in the oral form.
While corticosteroids can help keep the immune system from attacking your arteries, other types of immunosuppressive medications may be needed. This is especially true if your PAN symptoms are severe.
Antiviral medications are primarily used in patients with hepatitis infections.
Complications of PAN
Conditions affecting the blood vessels are very serious. If your arteries are damaged, it can ultimately affect your brain, heart, and other vital organs.
According to the National Institutes of Health, the most common complications of PAN include:
- heart attack
- severe intestinal damage
- kidney failure (NIH, 2012)
Long-Term Outlook for PAN
The outlook for this condition depends on the course of treatment. Patients who don’t get medical care can die from related complications. On the flip side, taking prescribed medications on a regular basis can reduce PAN symptoms and improve your chances of survival. There is no known way to prevent PAN, so your best chance for recovery is to stick to your treatment plan.