Polyarteritis Nodosa (PAN)

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Polyarteritis nodosa (PAN) is a systemic disease that affects small- and medium-sized arteries.
Polyarteritis nodosa is a systemic disease characterized by inflammatory necrosis of the walls of small- and medium-sized arteries.
Although the disease is systemic,it is patchy and focal, only parts of some arteries being
involved.
The clinical effects of the disease are the result of vessel occlusion leading to small areas of infarction, and the tissues most seriously affected are the kidneys, heart, alimentary tract, liver, central nervous system, peripheral nerves, skeletal muscle, and skin.

The cause of the disease is unknown, but it is likely to be immune-complex-mediated. There is an association with chronic hepatitis B virus antigenaemia.

The artery wall shows infiltration by mixed inflammatory cells, in which neutrophils and eosinophils are most numerous.

Fibrinoid necrosis of a segment of the artery wall is very common.
The inflammatory destruction leads to disruption of the normal architecture of the vessel wall, with necrosis of muscle cells and destruction of the elastic lamina; healing is followed by fibrous replacement of these specialized structures.
During the acute inflammatory phase, the extensive damage to the intima predisposes to thrombosis, which is often followed by vessel occlusion and infarction of the target tissue.
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