{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:58:49Z","timestamp":1792299529109,"version":"4.4.0"},"reference-count":14,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,13]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>We reported a unique case with the coexistence of classic and cutaneous polyarteritis nodosa (PAN), and microscopic polyangiitis (MPA) in hepatitis virus-associated vasculitis. A 77-year-old Asian man presented with extremity weakness and weight loss found to have bilateral foot drop and rash on his hands and legs. Labs reveal positive for hepatitis B core antibody and perinuclear-antineutrophil cytoplasmic antibody (p-ANCA), decreased C3 and C4 levels. Skin biopsy of rash shows medium vessel vasculitis suggesting PAN. Interestingly, renal biopsy showed features of necrotising medium-sized arteritis consistent with PAN and focal crescentic glomerulonephritis consistent with MPA. The patient was treated with 1\u2009g of solumedrol daily for 3\u2009days, followed by oral steroids and cyclophosphamide treatment for vasculitis, and entecavir for chronic hepatitis B infection, resulting in resolution of symptoms. The patient has not had a relapse at 6 months.<\/jats:p>","DOI":"10.1136\/bcr-2020-240015","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T13:44:09Z","timestamp":1621431849000},"page":"e240015","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Hepatitis B virus infection associated with polyarteritis nodosa and microscopic polyangiitis"],"prefix":"10.1136","volume":"14","author":[{"given":"Zhou","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Cui","sequence":"additional","affiliation":[{"name":"Integrated Medical Care, L.L.C, Rockville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lois","family":"Arend","sequence":"additional","affiliation":[{"name":"Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal","family":"Mikdashi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, USA"},{"name":"Rheumatology and Clinical Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"2025082802424991000_14.5.e240015.1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"2025082802424991000_14.5.e240015.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.02.015"},{"key":"2025082802424991000_14.5.e240015.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jceh.2013.06.001"},{"key":"2025082802424991000_14.5.e240015.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2015.08.008"},{"key":"2025082802424991000_14.5.e240015.5","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/00004836-199507000-00011","article-title":"Chronic leukocytoclastic vasculitis complicating HBV infection. 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Treatment of ANCA-Associated Vasculitides. In: Anti-Neutrophil cytoplasmic antibody (ANCA) associated vasculitis. Springer, Cham, 2020: 313\u201328.","DOI":"10.1007\/978-3-030-02239-6_17"},{"key":"2025082802424991000_14.5.e240015.13","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1080\/1744666X.2019.1656527","article-title":"Treatment of systemic necrotizing vasculitides: recent advances and important clinical considerations","volume":"15","author":"Pagnoux","year":"2019","journal-title":"Expert Rev Clin Immunol"},{"key":"2025082802424991000_14.5.e240015.14","doi-asserted-by":"crossref","unstructured":"Ijaz SH , Taseem S , Usman K . Relapsing hepatitis B (HBV)- associated vasculitis with features of polyarteritis nodosa (PAN) and cANCA-associated vasculitis. 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