ACR Criteria for the Classification of Polyarteritis Nodosa (PAN)

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American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa (PAN). Classified as PAN if at least three of the 10 criteria are present:

  1. Weight loss > 4 kg: Loss of >4 kg body weight since illness began, not related to dieting or other factors.
  2. Livedo reticularis: Mottled reticular pattern over the skin of portions of the extremities or torso.
  3. Testicular pain/tenderness: Pain or tenderness of the testicles, not due to infection, trauma or other causes.
  4. Myalgias, weakness or leg tenderness: Diffuse myalgias (excluding shoulder or hip girdle) or weakness of muscles or tenderness of leg muscles.
  5. Mono- or polyneuropathy: Development of mononeuropathy, multiple mononeuropathies or polyneuropathy.
  6. Diastolic BP >90 mmHg: Development of hypertension with the diastolic BP higher than 90 mmHg.
  7. Elevated BUN or creatinine: Elevation of BUN >40 mg/dl or creatinine >1.5 mg/dl, not due to dehydration or obstruction.
  8. Hepatitis B virus: Presence of hepatitis B surface antigen or antibody in serum.
  9. Arteriographic abnormality: Arteriogram showing aneurysms or occlusions of the visceral arteries, not due to arteriosclerosis, fibromuscular dysplasia or other non-inflammatory causes.
  10. Biopsy of small or medium-sized artery containing polymorphonuclear cells: Histologic changes showing the presence of granulocytes or granulocytes and mononuclear leucocytes in the artery wall.

These criteria have a reported sensitivity of 82.2% and a reported specificity of 86.6% for the classification of polyarteritis nodosa compared with other vasculitides.

 

References:

  1. Lightfoot RW, Michel BA, Bloch DA, Hunder GG, Zvaifler NJ, McShane DJ, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum. 1990;33:1088-93.[Medline]

Created: May 29, 2005