Polyarteritis nodosa (PAN): what to watch for and what to expect

Polyarteritis nodosa, or PAN, is a rare form of vasculitis that inflames medium-sized arteries. It can hit many organs — skin, nerves, gut, kidneys — so symptoms vary. If you feel unexplained fevers, sudden high blood pressure, stomach pain after meals, numbness in a limb, or odd skin spots, PAN is one of the conditions your doctor may consider.

How doctors diagnose PAN

Diagnosis starts with your story and a physical exam. Blood tests often show inflammation (high ESR or CRP) but aren’t specific. Unlike some other vasculitis types, ANCA antibodies are usually negative in PAN. Imaging like an angiogram or CT angiography can reveal small aneurysms or narrowed arteries. A tissue biopsy, when possible, gives the clearest answer because it can show artery inflammation under the microscope.

Expect your doctor to check for infections too. Hepatitis B has been linked to PAN in some cases, and treating that infection changes the treatment plan.

Treatment and what you can do

Treatment aims to stop the artery inflammation quickly. High-dose corticosteroids are the usual first step to calm inflammation. For more severe or organ-threatening disease, doctors add immunosuppressants such as cyclophosphamide. If hepatitis B is involved, antiviral therapy and sometimes plasma exchange are part of the plan instead of strong long-term immunosuppression.

Follow-up is key. Your doctor will monitor blood pressure, kidney function, and signs of relapse. Don’t skip medication or follow-up scans — early control lowers the risk of permanent damage to nerves, intestines, or kidneys.

Practical things you can do now: keep a simple symptom diary (new numbness, skin changes, abdominal pain, or fevers), track your blood pressure at home, and bring questions to appointments. Ask your team which vaccines you should get before starting strong immune medicines. If you smoke, find help to quit — smoking raises vascular risk and can complicate recovery.

When should you see a doctor fast? Go to urgent care or your clinic if you have sudden, severe belly pain, leg weakness, sudden vision changes, chest pain, or very high blood pressure. Those can signal serious organ problems that need quick action.

PAN is serious but treatable when detected early. With prompt therapy and regular follow-up, many people control symptoms and avoid major complications. If you suspect something unusual with nerves, skin, belly pain, or blood pressure spikes, mention PAN to your clinician as part of the discussion. Clear communication and timely testing make a big difference.