Pediatric Nephrology

, Volume 22, Issue 1, pp 97–100 | Cite as

Hypertensive crisis, hepatitis B virus and polyarteritis nodosa in a child

  • Alexandre Belot
  • Bruno Ranchin
  • Isabelle Canterino
  • Christian Trepo
  • Laurence Dubourg
  • Pierre Cochat
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

We report on a case of hepatitis B virus-related polyarteritis nodosa (PAN) in a 4-year-old Turkish boy who was first admitted because of severe arterial hypertension. The diagnosis of PAN was provided by conventional renal arteriography and the child was successfully treated with intensive sequential therapy combining short-term prednisone, plasma exchange and interferon-α-2b. Nine years later, he had no sign of PAN, normal blood pressure and normal renal function in the absence of any treatment.

Keywords

Child Hepatitis B Arterial hypertension Interferon-alpha Polyarteritis nodosa 

Abbreviations

ALAT

Aspartate aminotransferase

ASAT

Alanine aminotransferase

ASLO

Antistreptolysine O

ESR

Erythrocyte sedimentation rate

GFR

Glomerular filtration rate

HBV

Hepatitis B virus

IFN

Interferon

N

Normal value

PAN

Polyarteritis nodosa

PE

Plasma exchange

Scr

Serum creatinine

This is a preview of subscription content, log in to check access.

References

  1. 1.
    Gocke DJ, Morgan C, Lockshin M, Hsu K, Bombardieri S, Christian CL (1970) Association between polyarteritis and Australia antigen. Lancet ii:1149–53CrossRefGoogle Scholar
  2. 2.
    Trepo C, Zuckerman AS, Bird RC, Prince AM (1974) The role of circulating hepatitis B antigen/antibody immune complexes in the pathogenesis of vascular and hepatic manifestations in polyarteritis nodosa. J Clin Pathol 27:863–868PubMedCrossRefGoogle Scholar
  3. 3.
    Reznik VM, Mendoza SA, Self TW, Griswold WR (1981) Hepatitis B-associated vasculitis in an infant. J Pediatr 98:252–254PubMedCrossRefGoogle Scholar
  4. 4.
    Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT (1990) The American College of Rheumatology 1990 criteria for classification of giant cell arteritis. Arthritis Rheum 33:1122–1128PubMedCrossRefGoogle Scholar
  5. 5.
    Trepo C, Guillevin L (2001) Polyarteritis nodosa and extrahepatic manifestation of HBV infection: the case against auto-immune intervention in pathogenesis. J Autoimmun 16:269–274PubMedCrossRefGoogle Scholar
  6. 6.
    Gilbert RD, Wiggelinkhuizen J (1994) The clinical course of hepatitis B virus-associated nephropathy. Pediatr Nephrol 8:11–14PubMedCrossRefGoogle Scholar
  7. 7.
    Cohen L, Guillevin L, Meyrier A, Bironne P, Bletry O, Godeau P (1986) L’hypertension artérielle maligne de la périarterite noueuse: incidence, particularité clinico-biologique et pronostic à partir d’une série de 165 cas. Arch Mal Cœur Vaiss 79:773–778PubMedGoogle Scholar
  8. 8.
    Guillevin L, Cohen P (2000) Périarterite noueuse: caractéristique clinique, pronostic et traitement. Ann Med Int 151:184–192Google Scholar
  9. 9.
    Guillevin L, Leenhardt A, Herson S, Meisel C, Blétry O, Godeau P (1983) Le système rénine-angiotensine au cours des hypertensions artérielles de la périarterite noueuse et de la sclérodermie. Ann Med Int 133:245–250Google Scholar
  10. 10.
    Topaloglu R, Kazik M, Saatci I, Kalyoncu M, Cil BE, Akalan N (2005) An unusual presentation of classic polyarteritis nodosa in a child. Pediatr Nephrol 20:1011–1015PubMedCrossRefGoogle Scholar
  11. 11.
    Brogan PA, Davies R, Gordon I, Dillon M (2002) Renal angiography in children with polyarteritis nodosa. Pediatr Nephrol 17:277–283PubMedCrossRefGoogle Scholar
  12. 12.
    Roberti I, Reisman L, Churg J (1993) Vasculitis in childhood. Pediatr Nephrol 7:479–489PubMedCrossRefGoogle Scholar
  13. 13.
    Ozen S, Besbas N, Saatci U, Bakkaloglu A (1992) Diagnostic criteria for polyarteritis nodosa in childhood. J Pediatr 120:206–209PubMedCrossRefGoogle Scholar
  14. 14.
    Guillevin L (1991) Les critères diagnostiques de la périartérite noueuse. Rev Med Int 12:101–103CrossRefGoogle Scholar
  15. 15.
    Ozen S, Anton J, Arisoy N, Bakkaloglu A, Besbas N, Brogan P, Garcia-Consuegra J, Dolezalova P, Dressler F, Duzova A, Ferriani VP, Hilario MO, Ibanez-Rubio M, Kasapcopur O, Kuis W, Lehman TJ, Nemcova D, Nielsen S, Olivera SK, Schikler K, Sztajnbok F, Terreri MT, Zulian F, Woo P (2004) Juvenile polyarteritis: results of a multicenter survey of 110 children. J Pediatr 145:517–522PubMedCrossRefGoogle Scholar
  16. 16.
    Guillevin L, Lhote F, Sauvaget F, Deblois P, Rossi F, Levallois D, Pourrat J, Christoforov B, Trepo C. (1994) Treatment of polyarteritis nodosa related to hepatitis B virus with interferon-alpha and plasma exchanges. Ann Rheum Dis 53:334–337PubMedCrossRefGoogle Scholar
  17. 17.
    Simsek H, Telatar H (1995) Successful treatment of hepatitis B virus associated polyarteritis nodosa by interferon alpha as first line therapy. J Hepatol 28:525–526Google Scholar
  18. 18.
    Nakamura H, Shimizu T, Ohshiro S, Aoki H, Kaneto M, Shioda A, Saitoh T, Moriyama M, Tanka N, Arakawa Y (2002) An adult patient with acute hepatitis type B which was protracted and complicated by polyarteritis nodosa: a case report. Hepatol Res 24:439–444PubMedCrossRefGoogle Scholar
  19. 19.
    Guillevin L, Mahr A, Cohen P, Larroche C, Queyrel V, Loustaud-Ratti V, Imbert B, Hausfater P, Roudier J, Bielefeld P, Petitjean P, Smadja D; French Vasculitis Study Group (2004) Short-term corticosteroids then lamivudine and plasma exchanges to treat hepatitis B virus-related polyarteritis nodosa. Arthritis Rheum 51:482–487PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2006

Authors and Affiliations

  • Alexandre Belot
    • 1
  • Bruno Ranchin
    • 1
  • Isabelle Canterino
    • 2
  • Christian Trepo
    • 3
  • Laurence Dubourg
    • 1
  • Pierre Cochat
    • 1
    • 4
  1. 1.Néphrologie PédiatriqueHôpital Edouard HerriotLyonFrance
  2. 2.Radiologie PédiatriqueHôpital Edouard HerriotLyonFrance
  3. 3.Hépato-gastro-entérologieHôtel DieuLyonFrance
  4. 4.Departement de pédiatriqueHôpital Edouard HerriotLyonFrance

Personalised recommendations