title: Rapid improvement of distal vasculitis in PAN related to hepatitis B with alprostadil infusion: a case report.
abstract: Polyarteritis nodosa (PAN) related to hepatitis B is an uncommon vasculitis that is sometimes associated with the rapid progression of distal ischemia. A few recent reports have proposed the use of antiviral therapy. However, there is not yet a consensus for the standard treatment of this disease entity and none of these treatments have been focused on fast symptomatic improvement. We describe here a 39-year-old female patient with PAN related to hepatitis B infection who completely recovered from the acutely progressing ischemic manifestations of her distal extremities with the use of alprostadil infusion (prostaglandin E1). The reactivation of her hepatitis B infection after glucocorticoid and cyclophosphamide therapy was successfully managed by the antiviral lamuvudine therapy. Most importantly, the vasodilator together with the conventional therapy may be desirable in the early stages of the disease before irreversible ischemic tissue damage can occur.
authors.affiliation: Medicine/Rheumatology, IN-HA University Hospital, 7-206, Shin-Hung-Dong, 3rd St., Choong-Gu, 400-711 Incheon, South Korea.
authors.forename: Mie-Jin
authors.initials: MJ
authors.lastname: Lim
authors.forename: Seong Ryul
authors.initials: SR
authors.lastname: Kwon
authors.forename: Seunghee
authors.initials: S
authors.lastname: Lee
authors.forename: Won
authors.initials: W
authors.lastname: Park
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage* / Q000627:therapeutic use; D000792:Angiography; D001916:Brachial Artery / Q000502:physiology; D005260:Female; D005263:Femoral Artery / Q000502:physiology; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007262:Infusions, Intravenous; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D012039:Regional Blood Flow / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014657:Vasculitis / Q000473:pathology* / Q000821:virology; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil