Document Detail

Life-threatening complications of hepatitis B virus-related polyarteritis nodosa developing despite interferon-alpha2b therapy: successful treatment with a combination of interferon, lamivudine, plasma exchanges and steroids.
MedLine Citation:
PMID:  11529642     Owner:  NLM     Status:  MEDLINE    
Polyarteritis nodosa (PAN) is a rare vasculitis associated with hepatitis B virus (HBV) infection in a significant proportion of cases. When used to treat HBV-related PAN, immunosuppressive agents may enhance viral replication and relaspes are frequent. In recent years the use of antiviral drugs has been proposed. We report the case of a patient with HBV-related PAN who, despite 6 weeks of interferon-alpha2b (IFN-alpha2b) monotherapy, developed life-threatening complications with bowel perforation. He was thereafter successfully treated with a combination of IFN-alpha2b, lamivudine, plasma exchanges and short-term steroids. In contrast to IFN-alpha2b, lamivudine is effective in rapidly suppressing viral replication. This may be valuable in the treatment of HBV-related PAN by contributing to a faster diminution of circulating immune complex levels. This case report highlights the importance of aggressive combined therapy in patients with HBV-related PAN.
P Deléaval; P Stadler; E Descombes; E Hecker; G Schrago; C Chizzolini; A Nicole; P Pugin; C Regamey
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical rheumatology     Volume:  20     ISSN:  0770-3198     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2001  
Date Detail:
Created Date:  2001-08-31     Completed Date:  2002-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  290-2     Citation Subset:  IM    
Hôpital Cantonal, Fribourg, Switzerland.
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MeSH Terms
Combined Modality Therapy
Critical Illness
Disease Progression
Drug Therapy, Combination
Follow-Up Studies
Hepatitis B / complications*,  diagnosis,  drug therapy
Hepatitis B virus / drug effects,  isolation & purification
Interferon Alfa-2b / administration & dosage*
Lamivudine / administration & dosage*
Plasma Exchange / methods*
Polyarteritis Nodosa / diagnosis,  therapy*,  virology*
Risk Assessment
Steroids / administration & dosage*
Treatment Outcome
Reg. No./Substance:
0/Steroids; 134678-17-4/Lamivudine; 99210-65-8/Interferon Alfa-2b
Comment In:
Clin Rheumatol. 2001;20(4):237-8   [PMID:  11529627 ]

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