Periarteritis nodosa Done by Issa A. Checked by Kistaubayeva Z.K.

Periarteritis nodosa O systemic necrotizing vasculitis with a primary lesion of arteries of medium and small caliber and secondary changes in organs and systems.

Classification O Clinical options: O classical (renal-visceral, renal- polyneuritic); O asthmatic; O dermal-thromboanic; O monoorganic

Etiology O The etiology is not fully understood. O The viral nature of the disease is discussed, in particular the role of the hepatitis B virus (HBSAg and its antibodies are found in the blood of patients). O Predisposing factors O past infections O intoxication, O the introduction of vaccines, serums, O medication O hypothermia O insolation

Lab diagnosis O Neutrophilic leukocytosis, eosinophilia, increased ESR appear in the peripheral blood. O In the study of the biochemical composition of blood hypoproteinemia is noted by reducing the content of albumin, an increase in the alpha-2- and gamma-globulin fractions, an increase in the amount of fibrinogen

Treatment O Immune depressants prednisone, azathioprine, cyclophosphamide. O For all acute and subacute variants of the disease, prednisone is prescribed in a daily dose of mg for 1-2 months, followed by a reduction to maintenance doses of mg per day. In the absence of the effect of glucocorticoids, as well as in severe kidney damage with persistent arterial hypertension, severe systemic manifestations (abdominal syndrome, pneumonitis, polyneuritis), a combination of prednisolone and cytostatics (azathioprine, cyclophosphamide) is shown.

Azathioprine is prescribed in a daily dose of mg in combination with mg of prednisone. The dose of cyclophosphamide is mg. Maintenance dose of azathioprine and cyclophosphamide mg. The duration of glucocorticoid and cytostatic therapy varies from one to several years and is determined by the persistence of the effect obtained, the peculiarity of the course of the disease and the nature of organ manifestations. Among other methods of treatment using plasmapheresis, hemosorption.

In order to correct DIC and improve the rheological properties of blood, the use of heparin, trental, and chimes is shown. Patients with periarteritis nodosa should avoid the administration of vaccines and serums, insolation, cooling, PTF, group B vitamins. Antibiotics, sulfonamides and other drugs.

Compliants: O heart attacks of various organs and their sclerosis; O hemorrhages (aneurysm rupture); O perforation of ulcers; O intestinal gangrene; O development of uremia; O violation of cerebral circulation; O encephalomyelitis.

Predictions O With periarteritis nodosa, the prognosis is unfavorable, especially in acute forms. O Immunosuppressive therapy may slow down the course of the disease and lead to stabilization of the process; in 50% of cases, remission and recovery can be achieved. O Disability of patients is usually reduced or steadfastly lost.