Lim Mie-Jin, Kwon Seong Ryul, Lee Seunghee, Park Won
Medicine/Rheumatology, IN-HA University Hospital, 7-206, Shin-Hung-Dong, 3rd St., Choong-Gu, 400-711 Incheon, South Korea.
Rheumatol Int. 2006 Aug;26(10):928-32. doi: 10.1007/s00296-006-0103-x. Epub 2006 Jan 25.
Polyarteritis nodosa (PAN) related to hepatitis B is an uncommon vasculitis that is sometimes associated with the rapid progression of distal ischemia. A few recent reports have proposed the use of antiviral therapy. However, there is not yet a consensus for the standard treatment of this disease entity and none of these treatments have been focused on fast symptomatic improvement. We describe here a 39-year-old female patient with PAN related to hepatitis B infection who completely recovered from the acutely progressing ischemic manifestations of her distal extremities with the use of alprostadil infusion (prostaglandin E1). The reactivation of her hepatitis B infection after glucocorticoid and cyclophosphamide therapy was successfully managed by the antiviral lamuvudine therapy. Most importantly, the vasodilator together with the conventional therapy may be desirable in the early stages of the disease before irreversible ischemic tissue damage can occur.
与乙型肝炎相关的结节性多动脉炎（PAN）是一种罕见的血管炎，有时与远端缺血的快速进展有关。最近的一些报告提出使用抗病毒治疗。然而，对于这种疾病实体的标准治疗尚未达成共识，并且这些治疗方法均未专注于快速的症状改善。我们在此描述一名39岁的女性患者，她患有与乙型肝炎感染相关的PAN，通过使用前列地尔输注（前列腺素E1），其远端肢体急性进展性缺血表现完全康复。糖皮质激素和环磷酰胺治疗后她的乙型肝炎感染再激活通过抗病毒拉米夫定治疗成功得到控制。最重要的是，在不可逆的缺血性组织损伤发生之前，在疾病的早期阶段，血管扩张剂与传统疗法联合使用可能是可取的。
