Under periarteritis nodosa mean systemic necrotizing vasculitis that predominantly affects the arteries of medium and small caliber.It is characterized by changes in secondary organs and systems.Clinical illness begins with fever, arthralgia, myalgia, joined by cutaneous, abdominal, trombangiitichesky, cardiac, pulmonary, renal, neurological syndromes.To confirm the diagnosis of nodular periarteritis, provided holding a morphological examination of skin biopsies.
periarteritis nodosa periarteritis nodosa etiology is not clear until the end.It is assumed that the causes of nodular periarteritis is the impact of viruses, such as hepatitis B virus
Contributing factors to the development of the disease are taking medications, transferred intoxication, infection, administration of serums, vaccines, hypothermia, insolation.
Pathogenesis is to ensure that there is hyperergic reaction of the organism as a response to the etiological factors, autoimmune antigen-antibody reaction, the formation of i
immune complexes activate complement, thus directly damage blood vessels and form a chemotactic substances that attract neutrophils into the lesion.They phagocyted immune complexes, thus there is a release of a large number of lysosomal proteolytic enzymes that damage the structure of the vascular wall.
Signs periarteritis nodosa periarteritis nodosa
shown clinical signs of systemic.For the onset of the disease is characterized by the appearance of general symptoms, among which are the most constant fever, appearance of muscle-joint pain, progressive weight loss.At the beginning of the disease is especially pronounced increase in body temperature, and then, when there is organ pathology, fever disappears.For the disease characterized by the appearance of pain in the large joints, and calf muscles.
periarteritis nodosa periarteritis nodosa Symptoms include the appearance of a high undulating fever, falling in response to aspirin or corticosteroids, weakness, weight loss up to cachexia, weakness.
Skin becomes pale, marble hue acquire appears livedo, skin rash, subcutaneous nodules in the forearms, thighs, drumsticks.
When periarteritis nodosa in muscular-articular symptoms included myalgia, weakness, pain, muscle atrophy, migratory arthritis of major joints, polyarthralgia.
Diagnostics periarteritis nodosa
To diagnose nodular periarteritis need to pass urine to perform general analysis, in which the presence of the disease is determined by proteinuria, microscopic hematuria and cylindruria;blood marked signs of leukocytosis, anemia, hyperthrombocytosis.
biochemical picture of the increase in blood fractions γ- and α2-globulin, fibrin, sialic acids, seromucoid, PSA.
To clarify the diagnosis, with nodular periarteritis biopsy.During the examination of the fundus exhibit aneurysmal vascular changes.Using Doppler ultrasound renal vascular stenosis determined by them.When the survey radiography has been increasing and strain lung pattern.To diagnose cardiomyopathy, conduct an electrocardiogram, ultrasound of the heart.
For great diagnostic criteria periarteritis nodosa taken the presence of kidney damage, polyneuritis, koronarita, abdominal syndrome, bronchial asthma with eosinophilia.As an extra (small) criteria is the availability myalgia, fever, weight loss.
Treatment periarteritis nodosa
the treatment of nodular periarteritis different therapy duration and continuity, individual selection of tools and complex.The duration of therapy may reach 2-3 years.Given the form of the disease, it is carried out rheumatologist, cardiologist, nephrologist, pulmonologist and others.
early and uncomplicated forms can be adjusted by means of corticosteroid therapy with prednisone, with courses provided repeated 2-3 times a year.Between courses prescribers relating to the pyrazolone series (phenylbutazone) or aspirin.
If periarteritis nodosa complicated by nephrotic syndrome or malignant hypertension, the appointed immunodepressory-cytostatics (azathioprine, cyclophosphamide).
In the case of chronic periarteritis nodosa, flowing with muscle atrophy and neuritis, conduct physical therapy, hydrotherapy, massage.