title: A case of refractory cutaneous polyarteritis nodosa in a patient with hepatitis B carrier status successfully treated with tumor necrosis factor alpha blockade.
abstract: We describe a patient with refractory cutaneous polyarteritis nodosa (CPAN) with hepatitis B virus (HBV) carrier status who was successfully treated with tumor necrosis factor alpha (TNF-α) blockade, using etanercept, and we review 5 similar cases. We administered etanercept because of the occurrence of repeated flares despite aggressive therapy. C-reactive protein normalization; prednisolone dose-sparing; and absence of any adverse events, including HBV reactivation with nucleotide analogue administration, or renal dysfunction, have been achieved for 8 months. TNF-α blockade should be considered for intractable CPAN.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Zoshima
authors.forename: Masami
authors.initials: M
authors.lastname: Matsumura
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kakuchi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mizushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujii
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yamada
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawano
mesh_terms: D002353:Carrier State / Q000276:immunology*; D000068800:Etanercept; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000150:complications / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012871:Skin Diseases / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept