Nodular periarteritis (Kussmaul-Mayer disease): symptoms and treatment

Nodular periarteritis is a disease that affects small and medium-sized vessels. In official medicine, the disease is called necrotizing vasculitis. There is a name periarteritis, Kussmaul-Mayer disease, panarteritis. As the pathology develops, aneurysms are formed, repeated damage not only to tissues, but also to internal organs.



Clear age limits nodular periarteritis has not even affects children. However, according to statistics, in the risk group are, most often people 30-40 years old. Men get afflicted more often. To say exactly what is the causative agent for pathology, it is impossible. It can be both a virus and the body’s response to injected synthetic drugs, serums, vaccines.

Etiology

In the first place is an allergy:


  • food intolerance
  • allergy to medicines
  • «cold» allergy.

As for medicines, antibiotics, preparations with iodine, aminazine, and B vitamins are most often the allergen. That is why nodular periarteritis can even affect children.

The hepatitis B virus is also a factor that can lead to the development of the disease. It is detected in 60% of patients with periarteritis.

In addition, the disease can develop because of:


  1. hypothermia
  2. acute viral infection;
  3. A strong emotional shock or prolonged stay in a stressful situation
  4. Respiratory infection.

Symptoms

At the initial stage of the disease, there are such symptoms:


  • weakness;
  • sudden weight loss, for no apparent reason;
  • a headache that does not disappear even under the influence of an anesthetic drug
  • fever;
  • men have pain in the testicles, for no apparent reason;
  • abdominal pain.

As the disease progresses, and depending on the localization of periarteritis, spots on the skin of the blue color may appear, like bruising. As a rule, the disease can strike:


  1. kidney;
  2. heart;
  3. lungs
  4. central nervous system
  5. skin integument
  6. lungs
  7. Gastrointestinal tract
  8. peripheral nervous system

In other words, nodular periarteritis can affect almost any internal organ and skin. Depending on the localization of the disease, a common list of symptoms can be supplemented.

Renal damage

Such a subtype of pathology is observed most often. According to statistics, renal damage is observed in 75% of patients. Diagnosis at an early stage of development of this pathology is difficult, because laboratory tests (urinalysis) may not show any changes. At later stages of development, changes in the functioning of the heart (heart failure) and even visual impairment, up to blindness, are possible. Without timely and adequate treatment, the following complications develop:


  • Aneurysm
  • acute renal failure
  • disruption of the internal renal arteries
  • kidney infarction
  • Acute thrombosis of renal vessels.

CNS lesions

With this localization, the following are added to the general list of symptoms:


  1. Mental disorders
  2. Epilepsy attacks
  3. cramps.

In some cases, memory problems may occur. In addition, the patient’s sleep is disturbed. In severe cases without special medications the patient can not fall asleep.

Localization in the digestive tract

At the initial stage it is rather difficult to diagnose ailment, since the symptoms are very similar to food poisoning or an elementary disorder of the stomach. The same circumstance considerably slows down the process of treatment, since the patient does not turn to the doctor in time. At the initial stage, the symptomatology is the same as described above. As periarteritis develops:





  • bleeding;
  • Practically constant abdominal pain
  • digestive disorders (dyspepsia).

The danger of this type of localization is that the pathology can develop before cirrhosis of the liver. As a consequence — a fatal outcome. According to statistics, nodular periarteritis of the gastrointestinal tract is observed in 50-60% of patients.

Lesion of the lungs

This subtype of pathology is observed quite rarely. As a rule, it is most often found in women. The most typical symptoms with nodular periarteritis are as follows:


  1. fever;
  2. frequent cough with minor expectoration
  3. shortness of breath;
  4. unstable temperature

In some cases, the pathology may be supplemented with bronchial asthma. In mandatory diagnosis, there should be an x-ray study.

Heart Attack

The clinical periarteritis of the heart is almost not recognized. Most often, this occurs through morphological studies in 70% of patients with an ailment. With this pathology, there may be minor disruptions in the rhythm of the heart, short, sharp pain. Without timely diagnosis and comprehensive treatment, the ailment can lead to a heart attack.

Peripheral nervous system damage

It is this type of periarteritis localization that is the most striking indicator of an ailment at an early stage. In this case, the following is observed:


  • pain in the lower limbs;
  • difficulty in moving;
  • muscle atrophy
  • reduction of tendon reflexes.

The consequences of this type of pathology can be very different. Up to the loss of the possibility of independent movement.

Nodal periarteritis of the skin

According to statistics, such a lesion of the skin is observed in almost half of patients. On the skin, the «drawing» of the vessels brightly emerges, the color of it becomes crimson. More often such signs of a pathology are visible on the bottom extremities. At the same time, there are no unpleasant physical sensations (itching, burning, peeling). However, the skin may become more vulnerable.

Clinical picture of the disease in children

As for children, pathology is much less likely to affect the central nervous system.

The exact cause of the disease in children is not. But, as medical practice shows, nodular periarteritis can develop due to staphylococcal infection, virus and allergic reaction to planned injections.

Symptomatic of the disease is almost the same as described above. In young children, most often the vessels of the small intestine are affected. In this case, all the symptoms indicate acute appendicitis. Therefore, it is possible to begin correct treatment only after a full-fledged diagnosis is performed.

For older children, the same localization of nodular periarteritis is common, as in adults — the gastrointestinal tract, the nervous system, the brain and kidneys.

Especially dangerous is the disease for infants and young children (up to 7 years). Untimely treatment of a doctor can result in a fatal outcome. As a rule, the reason for this is:


  1. infarction
  2. kidney failure
  3. Hemorrhage in the brain

Therefore, in the presence of the above symptoms in children, it is worth immediately contacting a doctor.

Diagnostics

In the mandatory diagnosis of this disease, laboratory and instrumental studies. After a personal examination and detection of symptoms in the patient, he is assigned laboratory tests — a general analysis of urine and blood. In addition, it is carried out:


  • muscle biopsy;
  • CT of the abdominal cavity (if there is a suspicion of a gastrointestinal lesion)
  • Internal organs angiography
  • biopsy of the intestinal mucosa

Only after a complete diagnosis can I prescribe a course of treatment.

The diagnosis of periarteritis in the early stages is very complicated, because the symptoms and tests may indicate another disease — renal failure, heart attack or heart rhythm disorder, heart failure. Therefore, initially incorrect treatment may be prescribed.

Treatment

With nodular periarteritis, the emphasis is on medication. In case of significant complications, even a blood transfusion is possible. Since the disease affects mainly the kidneys, an organ transplant may be necessary.

With regard to drug treatment, the doctor appoints the following synthetic medications:


  1. corticosteroids;
  2. ACE inhibitors;
  3. Antiviral drugs.

Be sure to adhere to a special diet. Especially in the event that a gastrointestinal lesion is diagnosed. Also for the period of treatment should completely abandon the use of alcohol and smoking.

Forecast

If you do not promptly seek medical help in time, do not start the correct treatment, then even a lethal outcome is possible. The main reason for this is kidney failure, heart attack, cerebral hemorrhage.




In the absence of treatment, the average survival rate is 5%. Much depends on the stage at which periarteritis is detected, how the disease develops and the general condition of the patient. As practice shows, a more optimistic forecast from the course of treatment is observed with the progressing development of the disease, rather than the fulminant. In any case, the earlier the patient applies for medical care, the more likely to succeed. However, it is almost impossible to completely recover from the nodular periarteritis.