Ozen et al proposed diagnostic criteria for identifying pediatric patients with polyarteritis nodosa. This can help identify patients who should undergo further diagnostic studies to confirm the diagnosis. The authors are from Hacettepe Children's Hospital in Ankara, Turkey.
Age range of patients: 1 to 14 years
Major findings:
(1) renal involvement (proteinuria, hematuria, nephrotic syndrome, renal failure)
(2) musculoskeletal findings (myalgia, arthralgia)
Minor findings:
(3) cutaneous findings (livedo reticularis, maculopapular purpuric lesions, peripheral gangrene, subcutaneous nodules)
(4) gastrointestinal system involvement (abdominal pain, bleeding)
(5) peripheral neuropathy (numbness, paresthesias, polyneuropathy)
(6) central nervous system disease (encephalitic symptoms, abnormal CT scan, recurrent hemiparesis, ptosis, cranial nerve palsy, recurrent seizures)
(7) hypertension
(8) cardiac involvement (pericarditis, arrhythmias, cardiac failure, myocardial infarction)
(9) lung involvement (pulmonary infiltrate, pleural effusion, hemoptysis)
(10) constitutional symptoms (fever, anorexia, fatigue)
(11) acute phase reactants (elevated ESR, leukocytosis, elevated C-reactive protein)
(12) presence of hepatitis B surface antigen (HBsAg)
Criteria for diagnosis - all of the following:
(1) at least 1 major finding
(2) at least 5 of the 12 findings (major and minor combined)
(3) absence of antinuclear and anti-DNA antibodies
where:
• This implies (a) 2 major and >= 3 minor; OR (a) 1 major and >= 4 minor.
Limitations:
• The criteria need to be validated in other institutions and populations.
