The association of hepatitis B antigenemia with periarteritis nodosa (PAN) has been well described in the past decade1,2 and is probably caused by circulating immune complexes involving hepatitis B surface antigen (HBsAg).3 We describe a patient with prostatic vasculitis, a rather unusual presentation for PAN and one that is amenable to diagnosis by needle biopsy.
REPORT OF A CASE
A 55-year-old white man went to his physician with a six-week history of arthralgias, fatigue, and morning stiffness. He also complained of nocturia. A 2+ enlarged, irregular prostate was noted.Abnormal findings on laboratory studies included an SGOT level of 258 mU/mL (normal, 7 to 40 mU/mL) and an alkaline phosphatase level of 123 mU/mL (normal, 30 to 115 mU/mL). Radioimmunoassay for HBsAg was positive initially and remained positive three months later, at which time testing for hepatitis B antibody was negative. An initial diagnosis of anicteric hepatitis was
Cheatum DE, Sowell DS, Dulany RB. Hepatitis B Antigen-Associated Periarteritis Nodosa With Prostatic Vasculitis: Diagnosis by Needle Biopsy. Arch Intern Med. 1981;141(1):107–108. doi:10.1001/archinte.1981.00340010099020
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