Clinical features

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 involvement 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%