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Nephrol Dial Transplant (1999) 14: 2077-2079
© 1999 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Treatment of classic polyarteritis nodosa in 1999

Loïc Guillevin

Department of Internal Medicine, Hôpital Avicenne, Université Paris-Nord, Bobigny, France

Correspondence and offprint requests to: L. Guillevin, Department of Internal Medicine, Hôpital Avicenne, Université Paris-Nord, 125 rue de Stalingrad, F-93000 Bobigny, France.

Classic polyarteritis nodosa (PAN), so-called Kussmaul–Maier disease [1], was the first systemic vasculitis to be described. For decades, no treatment was available and disease mortality was high. In retrospective series, the 5-year survival rate was no more than 13% [2]. This `old' disease benefited from steroids and cytotoxic agents [3]. More recently, treatment has been optimized by taking into consideration several factors [4] such as aetiology, prognostic scores [5], pathogenesis, age and concomitant or pre-existing underlying disease(s).

In the following, we discuss the main therapeutic principles and analyse their impact on outcome.

General principles

Among vasculitides, PAN is an acute disease. Flares usually occur within a short period after the first clinical manifestations. . . . [Full Text of this Article]

Steroids and cytotoxic agents

Adaptation of treatment according to prognostic factors

Treatment of PAN associated with hepatitis B virus

Surgery

Adjuvant medical treatment

References


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X. Guo, R. Gopalan, S. Ugbarugba, H. Stringer, M. Heisler, M. Foreman, and C. Nzerue
Hepatitis B-Related Polyarteritis Nodosa Complicated by Pulmonary Hemorrhage
Chest, May 1, 2001; 119(5): 1608 - 1610.
[Abstract] [Full Text] [PDF]