What are the signs and symptoms of polyarteritis nodosa (PAN) in hepatitis C (Hep C)?

Updated: Apr 02, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

PAN is a rare systemic vasculitis caused by necrotizing lesions in small- and medium-sized arteries of the skin, nerves, muscles, joints, kidneys, liver, and GI tract. [61] More often associated with HBV infection, PAN results from aneurysmal dilatation, hemorrhage, or ulceration in the affected artery. In PAN, false-positive results for HCV are more common than true positive results for HCV. Protean manifestations result. Major systemic symptoms of fever, malaise, and prostration occur. Clinical manifestations result from organ involvement. Skin nodulation, ulceration, and palpable purpura are common. Mononeuritis multiplex is a common presentation. Acute muscle and abdominal pain and hypertension often occur.

HCV-polyarteritis nodosa represented about one fifth of HCV vasculitis in one series, tending to be severe with an acute clinical presentation yet with a good clinical remission rate. [62]


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