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January 1981

Hepatitis B Antigen-Associated Periarteritis Nodosa With Prostatic Vasculitis: Diagnosis by Needle Biopsy

Author Affiliations

From the Departments of Internal Medicine (Drs Cheatum and Sowell) and Urology (Dr Dulany), Dallas Medical and Surgical Clinic and Baylor University Medical Center Hospital.

Arch Intern Med. 1981;141(1):107-108. doi:10.1001/archinte.1981.00340010099020

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

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