title: Hepatitis B-related polyarteritis nodosa presenting necrotizing vasculitis in the hepatobiliary system successfully treated with lamivudine, plasmapheresis and glucocorticoid.
abstract: A 64-year-old man was admitted for alithiasic cholecystitis. Necrotizing vasculitis was detected in a gallbladder obtained at the cholecystectomy. Slight elevation of transaminases, HBe antigens and hepatitis B-DNA (HBV-DNA) were detected in the patient. Intrahepatic necrotizing vasculitis was also detected in the liver biopsy specimen, and he also suffered from peripheral neuropathy of suddenly onset. Based on the diagnosis of hepatitis B-related polyarteritis nodosa, lamivudine was initially administered, followed by plasmapheresis and glucocorticoid steroid therapy. These treatments brought satisfactory improvement of polyarteritis nodosa without exacerbation of liver function.
authors.affiliation: The First Department of Internal Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Takeshita
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukushima
authors.forename: Takashi
authors.initials: T
authors.lastname: Gotoh
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tsujino
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ida
authors.forename: Kan
authors.initials: K
authors.lastname: Toriyama
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002764:Cholecystitis / Q000150:complications; D005705:Gallbladder Diseases / Q000473:pathology / Q000628:therapy / Q000821:virology*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008107:Liver Diseases / Q000473:pathology / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D010488:Polyarteritis Nodosa / Q000473:pathology / Q000628:therapy / Q000821:virology*
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D019259:Lamivudine