• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Johns Hopkins Arthritis Center

Show Search
Hide Search
  • Disease Information
    • Rheumatoid Arthritis
    • Psoriatic Arthritis
    • Ankylosing Spondylitis
    • Osteoarthritis
    • Gout
    • Osteoporosis
  • Patient Corner
    • Drug Information Sheets
    • Managing Your Arthritis
    • RheumTV – Patient Education Video Library
  • Our Research
    • Patient-Centered Outcomes Research
    • Current Research Studies
    • The Camille Julia Morgan Arthritis Research and Education Fund
  • About Us
    • Appointment Information
    • Contact Us
    • Our Faculty
    • Our Staff
    • Rheumatology Specialty Centers
  • Donate
Home / Ask the Expert / Microscopic Polyangiitis or Polyarteritis Nodosa

Microscopic Polyangiitis or Polyarteritis Nodosa

April 24, 2007 By Arthritis Center

Question

An indisputable biopsy ten years ago indicated PAN which seemed at the time to be somewhat limited to skin and joints with a relapsing and remitting course. I have had a history of microscopic hematuria. Upon examination there were a significantly large number of casts, but creatinine clearance was fine, and there was no evidence of proteinuria. The nephrologist believes this indicates microscopic polyangiitis. The decision was made to remain on 15 mgs of methotrexate a week along with 10 mgs of prednisone rather than more aggressive cyclophosamide therapy unless there is further indication of damage as the hematuria was present all along and has not affected kidney function. Is it possible to have two forms of polyarteritis nodosa at the same time? Does the disease mutate? Does it amke a difference to treatment to have a different name attached to the same symptoms? Would a course of cyclophosamide help beat this into remission?

Answer

Yours is a complex question and it is hard to do it justie in this forum. Despite the similarities in the name, PAN and microscopic PAN are likely 2 separate diseases. Although both can affect the kidney, other organ systems are different. For instance microsopic PAN an affect the lungs while PAN does not. Microscopic PAN is associated with an antibody blood test called p-ANCA. Since many of the drugs used to treat both of these problems are similar, you are right that it may be more important how severe the kidney problem is and whether it progresses in determining whether or not to move forward with more aggressive therapy such as cylophosphamide.

Arthritis Center

Founded in 1998, the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike.

Primary Sidebar

Ask The Expert Topics

  • Alternative Therapies
  • Ankylosing Spondylitis
  • Associated With Other Illnesses
  • Bursitis and Tendinitis
  • Corticosteroids
  • Diet and Exercise
  • Disease Modifying Antirheumatic Drugs (DMARDs)
  • Enteropathic Arthritis
  • Fibromyalgia
  • General Arthritis
  • Gout, Pseudogout, Other
  • Infectious Arthritis
  • Myositis
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Osteoarthritis
  • Osteonecrosis
  • Osteoporosis
  • Polymyalgia Rheumatica
  • Psoriatic Arthritis
  • Reactive Arthritis
  • Regional Pain: Back and Neck
  • Rehabilitation
  • Rheumatoid Arthritis
  • Surgical Therapy
  • Systemic Lupus Erythematosus (SLE)
  • Systemic Sclerosis
  • Vasculitis
RheumTV Logo

Rheum.TV is an informational platform created to educate patients living with a rheumatic disease. With over 100 disease education videos produced by the team at Johns Hopkins Rheumatology.

Visit Rheum.TV

Footer

Johns Hopkins Rheumatology

  • Johns Hopkins Rheumatology
  • Johns Hopkins Lupus Center
  • Johns Hopkins Lyme Disease Research Center
  • Johns Hopkins Myositis Center
  • Johns Hopkins Scleroderma Center
  • Johns Hopkins Sjögren’s Syndrome Center
  • Johns Hopkins Vasculitis Center

Connect With Us

  • Facebook
  • Twitter
  • YouTube

Johns Hopkins Medicine

© 2023 Johns Hopkins Arthritis Center
Patient Privacy