Schirmer J H, Holl-Ulrich K, Moosig F
Klinik für Rheumatologie und Immunologie, Universitätsklinikum Schleswig-Holstein und Vaskulitisklinik, Klinikum Bad Bramstedt, Oskar-Alexander-Str. 26, 24576, Bad Bramstedt, Deutschland,
Z Rheumatol. 2014 Dec;73(10):917-26; quiz 926-7. doi: 10.1007/s00393-014-1483-z.
Polyarteritis nodosa (PAN) is a necrotizing vasculitis of medium size arteries that may affect various organs. The clinical appearance is very variable. The most common manifestations are of the skin, the peripheral nervous system presenting as mononeuritis multiplex and the mesenteric and renal blood vessels due to the development of stenoses and small aneurysms. Of the cases one third are estimated to be associated with hepatitis B virus (HBV). The therapy depends on the pathogenesis of the disease: primary PAN is treated with immunosuppressants, whereas patients with HBV-related PAN should receive antiviral therapy and plasmapheresis. Differentiating PAN from other forms of vasculitis can be difficult and requires complex differential diagnostics.
结节性多动脉炎(PAN)是一种可累及多个器官的中等大小动脉的坏死性血管炎。临床表现差异很大。最常见的表现为皮肤、表现为多发性单神经炎的周围神经系统以及由于狭窄和小动脉瘤形成而累及的肠系膜和肾血管。据估计,三分之一的病例与乙型肝炎病毒(HBV)相关。治疗取决于疾病的发病机制:原发性PAN用免疫抑制剂治疗,而HBV相关PAN患者应接受抗病毒治疗和血浆置换。将PAN与其他形式的血管炎区分开来可能很困难,需要进行复杂的鉴别诊断。