Correspondence
Polyarteritis nodosa associated with precore mutant hepatitis B virus infection
| The first 150 words of the full text of this article appear below. |
Currently there is a trend to support the use of antiviral
therapy as the first line treatment of polyarteritis nodosa (PAN) associated to hepatitis B virus (HBV) infection.1 2 A
combination of a short course of corticosteroids, plasma exchange, and
interferon 
(INF) has been proposed. However, we have doubts
about this approach in all cases and circumstances of PAN related to
HBV infection. One of these circumstances would be precore mutant HBV infection.
A 37 year old man was diagnosed with PAN. The initial clinical
manifestations were mononeuritis multiplex, orchitis, mild renal
failure (creatinine: 168 µmol/l, proteinuria of 0.6 g/dl), abdominal
pain, and prolonged fever. Leucocytosis (30 000 WBC, 80%
neutrophils), serum asparate aminotransferase: 94 U/L, serum alanine
aminotransferase: 244U/l, increased erythrocyte sedimentation rate (90 mm/h) and complement consumption were also observed. Histological
diagnosis was performed by testicular biopsy. Infection with HBV
precore mutant was present (HBsAg +, HBeAg 
, Anti HBe Ag +, Anti HBc
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