MSK: Polyarteritis Nodosa: Free MSRA Podcast

🎧 MSRA Deep Dive: Polyarteritis Nodosa (PAN)Welcome back to the MSRA Revision Podcast! Today we’re exploring Polyarteritis Nodosa, a rare but clinically significant vasculitis affecting medium-sized arteries 🩸. This condition can affect multiple organs — and it’s essential for exam prep!Whether you're revising for exams or reviewing real-world cases, this is your essential, high-yield guide 💥.🧠 What is PAN?PAN is a systemic necrotising vasculitis that affects medium-sized arteries, causing damage to vessel walls and ischemia.Key facts:🧱 Targets muscular arteries (NOT capillaries or venules)❌ No glomerulonephritis❌ Not ANCA-associated🚫 “PAN doesn’t play in lungs or glomeruli”🔍 Causes & Risk Factors⚠️ Cause unknown🔗 Linked with hepatitis B, hepatitis C, HIV, or autoimmune processes👥 Most common in adults aged 40–60, more frequent in men📉 Incidence falling due to hep B vaccination🧬 Rare genetic forms (DADA2 deficiency) also exist⚠️ Symptoms & Red Flags🌡️ Fever, fatigue, weight loss🩺 Hypertension (esp. new-onset)🦵 Mononeuritis multiplex (peripheral nerve damage)🧑‍⚕️ Testicular pain🖐️ Livedo reticularis🩸 Hematuria without glomerulonephritis💥 Abdominal pain (mesenteric ischemia risk)🧵 Skin: purpura, ulcers, subcutaneous nodules🧠 CNS, cardiac, and renal involvement = higher mortality risk🔬 Investigations🧪 Bloods: ↑ ESR/CRP, hepatitis serology❌ ANCA typically negative🔬 Biopsy: necrotising arteritis (muscle, skin, nerves)🖼️ Angiography: microaneurysms, stenosis, occlusions🧠 Advanced: PET-CT for vascular inflammation📋 ACR Criteria (Adults):Need ≥3 of: weight loss, livedo reticularis, testicular pain, myalgias, neuropathy, HTN, renal impairment, Hep B, arteriogram changes, or biopsy findings💊 Management Summary🎯 Goal: control inflammation, preserve organs, minimise relapse🌟 Mainstay:🥄 Corticosteroids (prednisolone ± IV pulse)💊 Cyclophosphamide for severe/systemic cases🧪 Azathioprine/Methotrexate for maintenance📌 Special cases:Hep B PAN: antivirals + plasma exchangeCutaneous PAN: NSAIDs ± low-dose steroidsDADA2 PAN: TNF inhibitorsChildhood PAN: IVIG, steroids, immunosuppressants if needed📈 Prognosis✔️ With treatment: 5-year survival >80%❌ Untreated: survival <20%🔁 Relapse rate <20%🧫 Complications: renal failure, stroke, bowel infarction, aneurysm rupture, treatment-related infections or malignancy📚 Useful MSRA Resources📝 Revision Noteshttps://www.passthemsra.com/topic/polyarteritis-nodosa-revision-notes/🧠 Flashcardshttps://www.passthemsra.com/topic/polyarteritis-nodosa-flashcards/📖 Q&A Accordion Noteshttps://www.passthemsra.com/topic/polyarteritis-nodosa-accordion-qa-notes/🧪 Rapid Quizhttps://www.passthemsra.com/topic/polyarteritis-nodosa-rapid-quiz/🧠 Full Quiz Accesshttps://www.passthemsra.com/quizzes/polyarteritis-nodosa/🎓 MSK Coursehttps://www.passthemsra.com/courses/msk-for-the-msra/🔖 Hashtags for Search & Engagement#MSRA #MSRARevision #PolyarteritisNodosa #Vasculitis #MedicalRevision #MSRAFlashcards #MSRAQuiz #RheumatologyMSRA #PassTheMSRA