This is attributed to the effects of the tumor combined with the negative side effects of the medication administered to treat PNP.Roughly 1/3 of the deaths from PNP stem from pulmonary insufficiency which is brought about by the action of PNP on the respiratory mucosa. It manifests as dyspnea and progresses to bronchiolitis obliterans (non-reversible obstructive lung disease) via an unknown mechanism. Risk Factors
As PNP is ultimately caused by the presence of a tumor, it is not contagious. There is no known way to predict who will become afflicted with it. Patients with cancer are therefore a group at risk. Although PNP has been known to affect all age groups, it is more likely to afflict middle-aged to older patients. Recent research
The Development of ELISA testing for specific diagnosis of PNP was released in 2009. The research focuses on the specific determination of autoantibodies involved in the mechanism of PNP. Specifically, antibodies against envoplakin and periplakin were being investigated. Further use of ELISA testing on these antibodies confirmed the presence of anti-envoplakin and anti-periplakin autoantibodies in patients with PNP.Further research in 2013 outlined the various types of assays that could be used to determine which antibodies were involved in PNP. Demonstration of certain antibodies in the serum was named as the basis for diagnosis of PNP.
The anus will excrete feces that is thought to attract male fleas for mating, described in a later section. The hypertrophic zone between tergites 2 and 3 in the abdominal region begins to expand a day or two after penetration and takes the appearance of a life belt. During this time, the flea begins to feed on the hosts blood.Stage 3 is divided into two substages, 3a and 3b. Stage 3a is 2–3 days after penetration is complete. In substage 3a, the fleas midsection swells, balloon-like, to the size of a pea. This expansion of the flea causes its integument to be stretched thin, a process called physogastrism. The swelling ends in the condition of physogastry, and results in the appearance of a white halo around a black dot at the center of the lesion. That dot is the rear end of the flea. In substage 3b, the chitin exoskeleton of tergites 2 and 3 increase in thickness, which gives the structure the look of a miniature caldera. Egg release is common in substage 3b, as are fecal coils. The eggs tend to stick to the skin.At about the 3rd week after penetration, stage 4 begins, which is also divided into two substages. In 4a, the flea loses its signs of vitality and appears near death. As a result, the lesion shrinks in size, turns brown, and appears wrinkled.