Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Mod Rheumatol. 2013 Sep;23(5):1029-33. doi: 10.1007/s10165-012-0732-8. Epub 2012 Sep 13.
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.
我们描述了一例伴有乙型肝炎病毒（HBV）携带状态的难治性皮肤多发性动脉炎（CPAN）患者，该患者使用依那西普成功接受了肿瘤坏死因子-α（TNF-α）阻断治疗，同时我们还回顾了 5 例相似病例。由于尽管进行了强化治疗，但仍反复发作，我们给予了依那西普治疗。治疗 8 个月后，患者 C-反应蛋白恢复正常，泼尼松龙剂量得以减少，且未出现任何不良反应，包括核苷酸类似物治疗导致的 HBV 再激活或肾功能障碍。对于难治性 CPAN，应考虑 TNF-α 阻断治疗。
