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

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 occurrenc...

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Published in:	Modern rheumatology 2013-09, Vol.23 (5), p.1029-1033
Main Authors:	Zoshima, Takeshi, Matsumura, Masami, Suzuki, Yasunori, Kakuchi, Yasushi, Mizushima, Ichiro, Fujii, Hiroshi, Yamada, Kazunori, Yamagishi, Masakazu, Kawano, Mitsuhiro
Format:	Article
Language:	English
Subjects:	Carrier State - immunology Case Report Etanercept Female Hepatitis B - complications Hepatitis B - immunology Hepatitis B virus - immunology Humans Immunoglobulin G - therapeutic use Immunosuppressive Agents - therapeutic use Medicine Medicine & Public Health Middle Aged Orthopedics Polyarteritis Nodosa - complications Polyarteritis Nodosa - drug therapy Receptors, Tumor Necrosis Factor - therapeutic use Rheumatology Skin Diseases - complications Skin Diseases - drug therapy Treatment Outcome
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container_title	Modern rheumatology
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creator	Zoshima, Takeshi Matsumura, Masami Suzuki, Yasunori Kakuchi, Yasushi Mizushima, Ichiro Fujii, Hiroshi Yamada, Kazunori Yamagishi, Masakazu Kawano, Mitsuhiro
description	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.
doi_str_mv	10.1007/s10165-012-0732-8
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subjects	Carrier State - immunology Case Report Etanercept Female Hepatitis B - complications Hepatitis B - immunology Hepatitis B virus - immunology Humans Immunoglobulin G - therapeutic use Immunosuppressive Agents - therapeutic use Medicine Medicine & Public Health Middle Aged Orthopedics Polyarteritis Nodosa - complications Polyarteritis Nodosa - drug therapy Receptors, Tumor Necrosis Factor - therapeutic use Rheumatology Skin Diseases - complications Skin Diseases - drug therapy Treatment Outcome
title	A case of refractory cutaneous polyarteritis nodosa in a patient with hepatitis B carrier status successfully treated with tumor necrosis factor alpha blockade
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