Question 18.
All of the following statements except one are true of polyarteritis nodosa (PAN). Which is the exception? (AI)
1. Associated with hepatitis B infection
2. Large-vessel vasculitis
3. Mononeuritis multiplex
4. Associated with hypertension
DISCUSSION:
Mononeuritis multiplex is seen in about half of patients with PAN. Renal involvement in PAN is in the form of arteritis without glomerulonephritis and manifests as hypertension and renal insufficiency. HBV was once the cause of up to 30% of PAN cases; however, its frequency has decreased over period of time and is now estimated to account for less than 10% of all PAN cases. Polyarteritis nodosa (PAN) is an example of medium-vessel (not large-vessel) vasculitis. Examples of large-vessel vasculitides are giant cell arteritis, Takayasu's arteritis, and isolated CNS angiitis.
ANSWER:
The correct answer is “large-vessel vasculitis.”
REFERENCE:
Stone JH. Polyarteritis nodosa. JAMA. Oct 2 2002;288(13):1632-9.
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