Polyarteritis acuta nodosa and periarteritis nodosa

Abstract

I. INTRODUCTORY. THE term " I'eriarteritis Nodosa " has been applied more or less promiscuously t o two entirely distinct diseases oi the smaller arteries, both of them extremely rare, and both arording problems of considerable interest and difficulty with regard to their histological characters and etiology. One of these conditions is probably a true pemhrteritis, commencing in and affecting chiefly the outer coat of the diseased vessel, though the media and intima may also be affected. For these cases it is desirable to retain the term (' periarteritis nodosa." To the other and still rarer group of cases, to which special attention will be given in this paper, the name '(Polyarteritis Acuta Nodosa," suggested by Ferrari, should be applied. This latter condition is chsracteriPed by the presence of small localised nodules situated upon the walls of the smaller and mediumsized arteries, these nodules having usually a widespread distribution throughout the organs and tissues, though in some cases they may be more or less restricted to the arteries of one or of a small group of the organs or tissues. These nodules are due to localised inflammatory, destructive, and proliferative changes occurring in the vessel wall, probably the most important part of the change being the complete destruction of localised areas in the muscular coat. This is accompanied or followed by the giving way of the internal elastic lamina and the inner and outer coats, in which there niay also be found well-marked inflammatory and proliferative changes, the first mentioned

Clinical and pathological classification of ANCA-associated vasculitis: what are the controversies?

“…Ferrari proposed using the term "polyarteritis acuta nodosa" rather than "periarteritis nodosa" because of the transmural rather than perivascular nature of the inflammatory lesions [6], This proposal was convincingly championed by Carnegie Dickson ofthe University of Edinburgh [7]. who published the first extensive account of the disease in the English language literature, although there had been earlier case reports, "Polyarteritis acuta nodosa" has been shortened to "polyarteritis nodosa" (PAN) and is currently the most widely used name for the pattern of arteritis described by Kussmal and Maier,…”

“…Half the patients are positive for ANCA [6]. Jennette and Falk demonstrated that perinuclear fluorescent staining, which is the pattern usually found, was often due to antibodies directed against myeloperoxidase (MPO) [7].…”

A history of early investigation in polyarteritis nodosa

“…In summarizing the case of a 45-year-old alcoholic man, Ferrari surmises that the vascular lesion is caused by a toxic substance that affects the nerve centers of the vessels (36). W. E. Carnegie Dickson in Edinburgh introduced the term polyarteritis nodosa to the English language literature in 1908 (18). Dickson distinguished "true periarteritis (italics original) commencing in and affecting chiefly the outer coat of the diseased vessel," and adopted the term polyarteritis acuta nodosa, as suggested by Ferrari, for the more rare form of arteritis associated with nodulosis of the small-and medium-sized arteries which are due to " .…”

Coronary Artery Aneurysms: An Update

“…Newly recognized types of this disease were characterized and classified according to features that were similar to or distinct from those of PAN (Klinger, 1931;Churg & Strauss, 1951). In the early 1900s, Ferrari (1903) and Dickson (1908) proposed the name polyarteritis nodosa, partly to distinguish the disorder described by Kussmaul & Maier (1866) from the vascular lesion of tertiary syphilis. Furthermore, the term polyarteritis nodosa emphasizes the panarteritic nature of this disease and underscores the fact that multiple arteries are affected by the process (Arkin, 1930).…”