Polyarteritis Nodosa: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Polyarteritis Nodosa?
A rheumatologist, a doctor who treats diseases of the joints, muscles, and immune system, usually leads care. Other specialists may help if the kidneys, gut, or nerves are affected. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is polyarteritis nodosa?
Polyarteritis nodosa, also called PAN, is a serious disease that inflames blood vessels. The small and medium-sized arteries become swollen and damaged. Arteries are the blood vessels that carry oxygen-rich blood to organs and tissues. The tissues fed by the damaged arteries do not get the oxygen and nourishment they need. PAN is a rare disorder that can affect many parts of the body. Damaged arteries may lead to high blood pressure, blood clots, or a bulge in an artery wall called an aneurysm.
Symptoms
Symptoms come from damage to the affected organs. The skin, joints, muscles, gut, heart, kidneys, and nervous system are often affected. Symptoms include:
- Abdominal pain and less appetite
- Tiredness, weakness, and fever
- Joint aches and muscle aches
- Weight loss without trying
- Testicular swelling and pain
If nerves are affected, you may have numbness, pain, burning, and weakness. Damage to the nervous system may cause strokes or seizures. The small and medium-sized arteries of the kidneys are most often involved.
Causes and who gets it
The cause of PAN is unknown. The disease happens when certain immune cells attack the affected arteries. Most scientists believe it is an autoimmune disease. This means the body's defenses attack healthy tissue. People with active hepatitis B or hepatitis C may develop this disease.
More adults than children get it. It usually affects people between 40 and 50 years of age, but it may occur in any age group.
How doctors diagnose it
No specific lab test can diagnose PAN. Other diseases have features like PAN, so doctors must rule them out. You will have a complete physical exam. Blood tests, a urine test, and tests for hepatitis B and C can help. Other tests may include an arteriogram, which takes pictures of the arteries. A tissue biopsy, which studies a small piece of tissue, may also be done.
Treatment
Treatment uses medicines that calm inflammation and the immune system. These may include steroids, such as prednisone. Medicines such as azathioprine, methotrexate, or mycophenolate are often used too. They let doctors use less steroid. Cyclophosphamide is used in severe cases. If PAN is linked to hepatitis, treatment may include plasmapheresis, a way to filter the blood, and antiviral medicines.
Current treatments can improve symptoms and the chance of long-term survival. Without treatment, the outlook is poor. The most serious complications most often involve the kidneys and gut.
When to see a doctor
Contact your health care provider if you develop symptoms of this disorder. Early diagnosis and treatment may improve the chance of a good outcome. PAN can cause a heart attack, a stroke, a seizure, or kidney failure. Call 911 or go to the emergency room if you have chest pain, a seizure, sudden weakness or trouble speaking, or severe abdominal pain.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A doctor like this can do a first evaluation and help coordinate care with a rheumatologist. They can also keep up with follow-up visits over time.
Common questions
Is polyarteritis nodosa serious?
Yes, it is a serious disease that inflames blood vessels. Without treatment, the outlook is poor. Current medicines can improve symptoms and the chance of long-term survival.
What causes polyarteritis nodosa?
The cause is unknown. It happens when certain immune cells attack the affected arteries. People with active hepatitis B or hepatitis C may develop it.
Is there a single test for polyarteritis nodosa?
No, no specific lab test can diagnose it. Doctors use an exam, lab tests, an arteriogram, and a tissue biopsy to help make the diagnosis.
Who gets polyarteritis nodosa?
Adults get it more often than children. It usually affects people between 40 and 50 years of age, but it may occur in any age group.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
