What are the ACR diagnostic criteria for polyarteritis nodosa (PAN)?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

In 1990, the American College of Rheumatology (ACR) established criteria for research purposes in order to differentiate PAN from other forms of vasculitis. [7] A committee of ACR physicians selected 10 disease features of PAN; in order for PAN to be diagnosed, at least 3 of the 10 ACR criteria should be present when a radiographic or pathological diagnosis of vasculitis is made [7] (see Presentation and Workup):

  • Weight loss of 4 kg or more
  • Livedo reticularis
  • Testicular pain/tenderness
  • Myalgia or leg weakness/tenderness
  • Mononeuropathy or polyneuropathy
  • Diastolic blood pressure greater than 90 mm/Hg
  • Elevated blood urea nitrogen (BUN) or creatinine level unrelated to dehydration or obstruction
  • Presence of hepatitis B surface antigen or antibody in serum
  • Arteriogram demonstrating aneurysms or occlusions of the visceral arteries
  • Presence of polymorphonuclear neutrophils in a biopsy specimen from a small- or medium-sized artery

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