clinical features

Last reviewed 01/2018

These are dependent on the particular clinical subgroup of polyarteritis that occurs. Generally, it is found in middle-aged men.

Initially features are non-specific:

• fever, malaise, weight-loss, arthralgia, myalgia

Later features may include:

• ear nose and throat - secretory otitis media, sensorineural deafness, epistaxis, nasal obstruction, ulceration of the hard or soft palate.
• lung - lower respiratory tract involvement in 45-65% of patients; common symptoms dyspnoea, cough, haemoptysis, pleuritic chest pain.
• joints - affected in about 60%; migratory polyarthralgia is a common symptom in prodrome.
• muscle - myalgia, weakness - muscle in involvement in 30-80% of patients.
• eye - red, painful (due to episcleritis) - eye involvement in 40-80% of cases.
• nervous system:
• PNS - affected in 50-70% of cases; peripheral neuropathy, mononeuritis multiplex.
• CNS - occurs in 25%
• GU tract:
• kidney involvment in 65-80%; poor prognosis.
• skin - lesions found in 20-50%; specific lesions eg skin necrosis, subcutaneous nodules, livedo reticularis. Non-specific manifestations such as macular erythema, erythema multiforme and erythema nodosum also may occur.
• CVS - MI, heart failure, arrhythmias.
• GI tract - 25-50%; gastrointestinal ischaemia, hepatomegaly in 40%.