A case of refractory cutaneous polyarteritis nodosa in a patient with hepatitis B carrier status successfully treated with tumor necrosis factor alpha blockade

Vol.23 No.5

Case Report

A case of refractory cutaneous polyarteritis nodosa in a patient with hepatitis B carrier status successfully treated with tumor necrosis factor alpha blockade

Authors

Takeshi Zoshima¹ , Masami Matsumura ² , Yasunori Suzuki¹ , Yasushi Kakuchi¹ , Ichiro Mizushima¹ , Hiroshi Fujii¹ , Kazunori Yamada¹ , Masakazu Yamagishi³ , Mitsuhiro Kawano¹

Division of Rheumatology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
Research Center for Medical Education, Graduate School of Medicine, Kanazawa University, Takara-machi 13-1, Kanazawa 920-8640, Japan
Division of Cardiology, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

Received:

5 April 2012

Accepted:

26 July 2012

Published online:

13 September 2012

Full Text

PDF　(member's only)

Abstract

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-a) 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-a blockade should be considered for intractable CPAN.

Key words

Cutaneous polyarteritis nodosa, Etanercept, Hepatitis B, Tumor necrosis factor alpha blockade