POLYARTERITIS (Polyarteritis Nodosa;Periarteritis Nodosa; Necrotizing Angiitis) |
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POLYARTERITIS (Polyarteritis Nodosa;
Periarteritis Nodosa; Necrotizing Angiitis)
DESCRIPTIONPolyarteritis is a disorder of connective tissue that is one of several related diseases of collagen tissue. Collagen is a protein molecule that forms the major part of all connective tissue. Polyarteritis causes inflammation of small and medium arteries, decreasing the blood supply to tissues supplied by the affected blood vessels. It is not contagious. All body parts are involved. It is more common in males than females and affects all ages.
Appropriate health care includes:
Self-care after diagnosis.
Doctor's treatment.
Surgery to remove part of the child's intestines, if they are involved.
Hospitalization for intensive treatment (severe cases).
SIGNS & SYMPTOMS
Varies, depending on which organ is affected by the decreased blood supply. The most common include:
Chest pain (heart involvement).
Shortness of breath (lung involvement).
Abdominal pain (intestinal and liver involvement).
Blood in the child's urine (kidney involvement).
Numbness and tingling of the child's hands and feet (nerve involvement).
The course may be acute, with fever, weight loss, and rapid deterioration. If the course is chronic, body tissues will waste away over several years.
CAUSES
This is considered a disease of autoimmunity or hypersensitivity, although the cause is uncertain. In many children, no predisposing factors can be found. Following are the most common preceding factors:
Bacterial infections.
Viral infections.
Use of certain drugs, including sulfa drugs, penicillin, antithyroid drugs, gold, and thiazide diuretics.
Vaccines.
RISK FACTORS
Family history of collagen or hypersensitivity disease; smoking.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies of the child's kidneys and blood, including sedimentation rate (See Glossary).
POSSIBLE COMPLICATIONSKidney failure and death, despite treatment.
PROBABLE OUTCOME
This condition is currently considered incurable. However, your child's symptoms can be relieved or controlled. Many patients live many years with the disease, and medical literature cites a few instances of unexplained recovery. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.
TREATMENT
HOME CARENo specific instructions except those listed under other headings.
MEDICATION
Your doctor may prescribe:
--Cortisone drugs in high doses until acute symptoms diminish. Then symptoms may be controlled by a schedule of 1 cortisone dose every other day. Give these to the child only as long as necessary. Long-term use of cortisone produces serious adverse effects.
--Drugs to treat disorders of organs involved with this serious disease, such as heart medications for heart involvement or antihypertensives for high blood pressure.
--Immunosuppressive drugs--either alone or with steroids--if other drugs fail. These drugs pose additional risks to your child, including severe generalized septic bacterial infections.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your child can resume normal activities gradually as symptoms improve.
DIET & FLUIDS
Low-salt diet (See Appendix 29).
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of polyarteritis.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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