Hepatitis B-related polyarteritis nodosa presenting necrotizing vasculitis in the hepatobiliary system successfully treated with lamivudine, plasmapheresis and glucocorticoid.
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.
Takeshita
Shigeyuki
S
The First Department of Internal Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki.
Nakamura
Hideki
H
Kawakami
Atsushi
A
Fukushima
Tetsuya
T
Gotoh
Takashi
T
Ichikawa
Tatsuki
T
Tsujino
Akira
A
Ida
Hiroaki
H
Toriyama
Kan
K
Hayashi
Tomayoshi
T
Eguchi
Katsumi
K
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*
D000998:Antiviral Agents; D005938:Glucocorticoids; D019259:Lamivudine