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 Nine pediatric (<18 years of age) and 28 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 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, neurologic involvement was more common and the duration of induction treatment was longer in adults (p=0.008 and p<0.001, respectively). Renal involvement was more common in adults than children, however this difference did not reach statistical significance. 4/28 (14.2%) adult and 3/9 (33.3%) pediatric patients had accompanying familial Mediterranean fever. Of adult patients, 85% (n=23) had received cyclophosphamide plus corticosteroid for induction treatment while three pediatric patients received CYC and four received mycophenolate mofetil addition to corticosteroid treatment.
Conclusions Although our study population is limited, neurologic and renal involvement were more common and the duration of induction treatment was longer in adults patients with PAN. There is no previous study comparing the characteristics of pediatric and adult patients with PAN Multicenter collaboration remains essential to determine the characteristic features of PAN in patients of different age groups.
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