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AB0641 Comparing the Characteristics of Adult and Pediatric Patients with Polyarteritis Nodosa
  1. A. Erden1,
  2. E.D. Batu2,
  3. Z.S. Arici2,
  4. E. Bilgin3,
  5. S. Apras Bilgen1,
  6. O. Karadag1,
  7. I. Ertenli1,
  8. S. Ozen2
  9. on behalf of Hacettepe University Vasculitis Center
  1. 1Department of Internal Medicine, Division of Rheumatology
  2. 2Department of Pediatrics, Division of Rheumatology
  3. 3Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey

Abstract

Background Polyarteritis nodosa (PAN) as a necrotizing vasculitis of medium or small arteries without glomerulonephritis or vasculitis in arterioles, venules or capillaries and not associated with antineutrophil cytoplasmic antibodies. It is more common in middle-aged adults when compared with children.

Objectives The aim of this study was to examine and compare the clinical characteristics of adult and pediatric patients with PAN.

Methods Six pediatric (<18 years of age) and ten adult patients with a clinical diagnosis of PAN who were seen at the Departments of Rheumatology and Pediatric Rheumatology, Hacettepe University, Ankara, Turkey were included in the study group. The pediatric and adult patients were classified as PAN according to the Ankara 2008 and American College of Rheumatology (ACR) 1990 criteria, respectively. The clinical features and response to therapy were evaluated retrospectively.

Results The characteristics of PAN patients were summarized in Table 1. According to the results with a statistical significance, female/male ratio was higher in children; neurologic and renal involvements were more common and the duration of induction treatment was longer in adults. 2/10 adult and 3/6 pediatric patients had accompanying familial Mediterranean fever. Ninety percent of adult patients had received cyclophosphamide plus corticosteroid for induction treatment while four pediatric patients received CYC and two received mycophenolate mofetil besides corticosteroid treatment.

Conclusions Our study, although the number is limited, have shown that neurologic and renal involvement were more common in adults with PAN and the duration of induction treatment was longer when compared with pediatric patients. There is no previous study comparing the characteristics of pediatric and adult patients with PAN; however, according to the previous studies, juvenile PAN has a more benign course than adult onset PAN. Multicenter collaboration remains essential to determine the characteristic features of PAN in patients of different age groups.

References

  1. Eleftheriou D, Batu ED, Ozen S, Brogan P. Vasculitis in children. Nephrol Dial Transplant 2014 Dec 30. pii: gfu393. [Epub ahead of print].

  2. Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798-806.

  3. Lightfoot RW Jr, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088-1093.

Disclosure of Interest None declared

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