Polyarteritis nodosa

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

RH No. 33 of 2020 · BoP No. 34 of 202016 factors

Meaning of polyarteritis nodosa: For the purposes of this Statement of Principles, polyarteritis nodosa: (a) means a non-granulomatous necrotising arteritis predominantly affecting medium or small arteries; and (b) includes cutaneous polyarteritis nodosa and single organ polyarteritis nodosa; and (c) excludes: (i) glomerulonephritis; (ii) Kawasaki disease; (iii) microscopic polyangiitis; and (iv) polyangiitis overlap syndrome.

Reasonable Hypothesis (RH) — Statement of Principles No. 33 of 2020

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting polyarteritis nodosa or death from polyarteritis nodosa with the circumstances of a person's relevant service:

(1)
having infection with hepatitis B virus at the time of the clinical onset of polyarteritis nodosa;
(2)
having infection with hepatitis C virus at the time of the clinical onset of polyarteritis nodosa;
(3)
having infection with human immunodeficiency virus at the time of the clinical onset of polyarteritis nodosa;
(4)
being treated with minocycline for at least the 12 months before the clinical onset of polyarteritis nodosa;
Note: Antineutrophil cytoplasmic antibodies may be associated with minocycline-induced polyarteritis nodosa.
(5)
having hairy cell leukaemia before the clinical onset of polyarteritis nodosa;
(6)
having had a hepatitis B vaccination within the three months before the clinical onset of polyarteritis nodosa;
(7)
having infection with hepatitis B virus at the time of the clinical worsening of polyarteritis nodosa;
(8)
having infection with hepatitis C virus at the time of the clinical worsening of polyarteritis nodosa;
(9)
having infection with human immunodeficiency virus at the time of the clinical worsening of polyarteritis nodosa;
(10)
being treated with minocycline for at least the 12 months before the clinical worsening of polyarteritis nodosa;
Note: Antineutrophil cytoplasmic antibodies may be associated with minocycline-induced polyarteritis nodosa.
(11)
inability to obtain appropriate clinical management for polyarteritis nodosa;

Aggravation-only factors: the factors in subsections 9(7) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 34 of 2020

5 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, polyarteritis nodosa or death from polyarteritis nodosa is connected with the circumstances of a person's relevant service:

(1)
having infection with hepatitis B virus at the time of the clinical onset of polyarteritis nodosa;
(2)
having infection with human immunodeficiency virus at the time of the clinical onset of polyarteritis nodosa;
(3)
having infection with hepatitis B virus at the time of the clinical worsening of polyarteritis nodosa;
(4)
having infection with human immunodeficiency virus at the time of the clinical worsening of polyarteritis nodosa;
(5)
inability to obtain appropriate clinical management for polyarteritis nodosa;

Aggravation-only factors: the factors in subsections 9(3) to 9(5) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Polyarteritis nodosa — DVA SoP factors