The reasons why periarteritis nodosa develops are still not exactly clear, but middle-aged men most often suffer from it. It is assumed that the virus becomes the culprit for the development of this dangerous vascular lesion, and the viral infection can become more active against the background of hypothermia or excessive exposure to the active sun, after taking certain medications or as a result of vaccination. Under the influence of these external factors, the body produces a hyperergic reaction, in which the resulting immune complexes settle on the walls of blood vessels and cause their inflammation. The endothelium of damaged vessels begins to produce factors for increased blood clotting, and the patient is at risk for thrombosis. The danger of periarteritis nodosa is that the vital vessels of any internal organs can be affected.

Types of vascular lesions in periarteritis nodosa

The classic form of periarteritis nodosa develops with skin lesions and renal-visceral symptoms. It usually has a benign course, with persistent remissions.

Thromboangiitis type of nodular periarteritis is accompanied by arterial hypertension, impaired microcirculation of blood and lymph in the extremities, and peripheral neuritis. This type of vascular disease progresses slowly, although with possible exacerbations of vascular inflammation.

In case of violations in the regimen prescribed by the doctor, with hypothermia, infection, and in some other cases, recurrent nodular periarteritis may develop. It may progress rapidly with kidney damage. 

Typical manifestations, diagnosis of periarteritis nodosa

The main diagnostic signs of periarteritis nodosa are severe weight loss of the patient, damage to the kidneys and coronary arteries of the heart, the presence of abdominal syndrome and polyneuritis, complaints of myalgia and fever.

The skin with periarteritis nodosa acquires a marble shade with a mesh pattern, there is a maculopapular rash against the background of erymatous manifestations. Subcutaneous nodules are found in the area of ​​the forearms and shins, they are located in the direction along the vascular bundles.

The fever manifests itself in waves, decreasing  in response to medication. The patient complains of muscle weakness, pain in large joints. The progression of the disease leads to the development of a renal symptom complex & nbsp; with vascular nephropathy, arterial hypertension, cardiovascular insufficiency, damage to the lungs, gastrointestinal tract, and other important organs and systems.

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Periarteritis nodosa treatment and possible complications

Uncomplicated periarteritis nodosa in the early stages is treated with courses of corticosteroids 2-3 times a year, pyrazolone preparations are prescribed between them. With the development of complications, cytostatics are prescribed, in case of hyperthrombocytosis, treatment with heparin, trental is supplemented.

Chronic nodular periarteritis with muscle atrophy requires the appointment of massage, physiotherapy. Plasmapheresis will help reduce blood viscosity, reduce the severity of autoimmune reactions.

The prognosis for the development of periarteritis nodosa is unfavorable due to severe vascular lesions. The development of thrombosis, renal failure, perforative complications of the gastrointestinal tract can be fatal, but with timely careful therapy, the progression of periarteritis nodosa can be stopped and remission can be achieved.

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