RESUMO
The clinical, biological, and immunological alterations of 20 patients with histologically confirmed classical panarteritis nodosa have been studied. Characteristic angiographic changes were present in 14 cases. There were 14 males and six females, with a mean age of 50 years. The main clinical manifestations were: fever (90%), peripheral nervous system involvement (80%), renal involvement (65%), arterial hypertension (60%), arthropathy (80%), and cutaneous lesions (45%). In most cases there was elevated VSG and alpha 2-globulin, anemia and leukocytosis. HBsAg positivity was found in five patients. The immunological study revealed a polyclonal immunoglobulin increase, changes in the complement components, and a quantitative and qualitative decrease of T lymphocytes. Steroids and immunosuppressive treatment were given to eight patients, and steroids along to 11 patients. The clinical evolution of 17 patients was followed; four patients died, all of them belonging to the group treated with steroid alone.