[A case of PAN with positive Hbs Ag cured by immunosuppressive and antiviral therapies: a case report].
Polyarteritis nodosa (PAN) first described by Kussmaul and Maier in 1866, is a multisystem necrotizing vasculitis of small and middle-sized muscular arteries. The presence of hepatitis B antigenemia (Hbs Ag) in approximately 30% of patients with PAN as well as immune complexes of Hbs Ag-Immunoglobulins and complement in the blood vessel walls strongly suggest the role of immunologic phenomena. The extremely poor prognosis of classic PAN has been modified by corticosteroid treatment with boluses of cyclophosphamide, and plasmapheresis. We report a case of PAN with renal, cardiac, central and peripheral nervous system involvement associated with active hepatitis B that got a total remission with corticosteroids, lamivudine and boluses of cyclophosphamide without plasmapheresis.
Choucair
Jacques
J
Service de Maladies infectieuses, CHU Hôtel-Dieu de France, Beyrouth, Liban. jacqueschoucair@hotmail.com
Hajj
Georges
G
Abi Karam
Ghada
G
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use; D010488:Polyarteritis Nodosa / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D005938:Glucocorticoids; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents; D019259:Lamivudine; D008776:Methylprednisolone Hemisuccinate; D003520:Cyclophosphamide; D011241:Prednisone