In this episode, we review polyarteritis nodosa (PAN), a rare systemic necrotizing vasculitis of medium and small arteries that leads to vessel inflammation, narrowing, thrombosis, and aneurysm formation. We discuss the underlying pathophysiology, including vascular injury and ischemia affecting multiple organ systems—most commonly the renal, dermatologic, neurologic, gastrointestinal, and cardiovascular systems. The episode highlights key clinical features such as hypertension from renal involvement, painful skin nodules, abdominal pain from intestinal ischemia, and mononeuritis multiplex. We also review diagnostic evaluation, including laboratory studies to rule out other vasculitides, the role of angiography or tissue biopsy, and the association with hepatitis B infection. Finally, we cover treatment strategies ranging from glucocorticoids and immunosuppressive therapy to antiviral management in hepatitis-associated disease, along with important clinical pearls to help clinicians recognize this high-yield systemic vasculitis.

References

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2. Stanton M, Tiwari V. Polyarteritis Nodosa. [Updated 2023 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482157/
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