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: Shigeyuki Takeshita, Hideki Nakamura, Atsushi Kawakami, Tetsuya Fukushima, Takashi Gotoh, Tatsuki Ichikawa, Akira Tsujino, Hiroaki Ida, Kan Toriyama, Tomayoshi Hayashi, Katsumi Eguchi
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 45 Issue 3 Pg. 145-9 ( 2006) ISSN: 1349-7235 [Electronic] Japan
• PMID: 16508228 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antiviral Agents
• Glucocorticoids
• Lamivudine

Topics

• Antiviral Agents (therapeutic use)
• Cholecystitis (complications)
• Gallbladder Diseases (pathology, therapy, virology)
• Glucocorticoids (therapeutic use)
• Hepatitis B (complications, drug therapy)
• Humans
• Lamivudine (therapeutic use)
• Liver Diseases (pathology, therapy, virology)
• Male
• Middle Aged
• Plasmapheresis
• Polyarteritis Nodosa (pathology, therapy, virology)