{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:16Z","timestamp":1789609096309,"version":"build-2803163510"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Immune-mediated diseases wherein immune complex-mediated injury is predominant; plasma exchange remains a therapeutic option for vasculitis. Hepatitis B virus-associated polyarteritis nodosa (HBV-PAN) wherein immunosuppressants can be contraindicated, plasma exchanges have a proven role when combined with antiviral therapy. Plasma exchange by hastening the clearance of immune complexes is beneficial in acute organ dysfunction. A 25-year-old male presented with complaints of generalized weakness, tingling numbness and weakness of extremities, joint pain, weight loss, and rashes over arms and legs for 2 months. Hepatitis B workup showed high viral loads of HBV (34 million IU\/ml) and hepatitis e antigen positivity (1129.06 U\/ml). Cardiac workup showed elevated cardiac enzymes and decreased ejection fraction (40%\u201345%). The finding of contrast-enhanced computed tomography (CECT) chest and abdomen with CT angiogram abdomen was steady with medium vessel vasculitis. A diagnosis of vasculitis with probable etiology of HBV-related PAN with mononeuritis multiplex and myocarditis was made. He was treated with steroids, tablet tenofovir, and 12 sessions of plasma exchanges. On average, 2078 ml of plasma was exchanged during each session with 4% albumin as a replacement fluid using central femoral line dialysis catheter as vascular access on automated cell separator Optia \u00aeSpectra (Terumo BCT, Lakewood, Co). He was discharged with the resolution of symptoms, including myocarditis and increase in power strength and still in follow-up. The present index case indicates that antiviral combined with plasma exchange after short-term corticosteroids is an effective therapy for HBV-PAN. TPE can be used as adjuvant therapy along with antiviral therapy in a rare disease like HBV-related PAN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ajts.ajts_70_22","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T04:48:23Z","timestamp":1664254103000},"page":"7-12","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Interesting rare case of polyarteritis nodosa related to hepatitis B virus and plasma exchange role? \u2013 A case report and review of the literature"],"prefix":"10.4103","volume":"17","author":[{"given":"Parmatma Prasad","family":"Tripathi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratti Ram","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag R.","family":"Kopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Basnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharanya","family":"Ramakrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divjot Singh","family":"Lamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rekha","family":"Hans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20240830","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.37715","article-title":"2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides","volume":"65","author":"Jennette","year":"2013","journal-title":"Arthritis Rheum"},{"key":"R2-2-20240830","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/hep.1840090116","article-title":"Hepatitis B-associated polyarteritis nodosa in Alaskan Eskimos: Clinical and epidemiologic features and long-term follow-up","volume":"9","author":"McMahon","year":"1989","journal-title":"Hepatology"},{"key":"R3-2-20240830","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1002\/art.1780330805","article-title":"The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa","volume":"33","author":"Lightfoot","year":"1990","journal-title":"Arthritis Rheum"},{"key":"R4-2-20240830","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1002\/art.20077","article-title":"Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener's granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000: A capture-recapture estimate","volume":"51","author":"Mahr","year":"2004","journal-title":"Arthritis Rheum"},{"key":"R5-2-20240830","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1159\/000199398","article-title":"Discontinuation of immunosuppressive therapy in hepatitis B surface antigen-positive chronic hepatitis: Effect on viral replication and on liver cell damage","volume":"36","author":"Hess","year":"1987","journal-title":"Digestion"},{"key":"R6-2-20240830","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1136\/ard.53.5.334","article-title":"Treatment of polyarteritis nodosa related to hepatitis B virus with interferon-alpha and plasma exchanges","volume":"53","author":"Guillevin","year":"1994","journal-title":"Ann Rheum Dis"},{"key":"R7-2-20240830","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/jca.21705","article-title":"Guidelines on the use of therapeutic apheresis in clinical practice \u2013 Evidence-based approach from the writing committee of the American Society for Apheresis: The eighth special issue","volume":"34","author":"Padmanabhan","year":"2019","journal-title":"J Clin Apher"},{"key":"R8-2-20240830","first-page":"1527","article-title":"Superiority of a new etiopathogenic treatment curing periarteritis nodosa caused by hepatitis B virus, using a combination of brief corticotherapy, vidarabine and plasma exchange","volume":"17","author":"Trepo","year":"1988","journal-title":"Presse Med"},{"key":"R9-2-20240830","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/00005792-199509000-00002","article-title":"Polyarteritis nodosa related to hepatitis B virus.A prospective study with long-term observation of 41 patients","volume":"74","author":"Guillevin","year":"1995","journal-title":"Medicine (Baltimore"},{"key":"R10-2-20240830","first-page":"289","article-title":"Treatment of polyarteritis nodosa related to hepatitis B virus with short term steroid therapy associated with antiviral agents and plasma exchanges.A prospective trial in 33 patients","volume":"20","author":"Guillevin","year":"1993","journal-title":"J Rheumatol"},{"key":"R11-2-20240830","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1007\/s10067-003-0857-4","article-title":"Treatment of hepatitis B virus-related polyarteritis nodosa: Two case reports and a review of the literature","volume":"23","author":"Deeren","year":"2004","journal-title":"Clin Rheumatol"},{"key":"R12-2-20240830","doi-asserted-by":"crossref","first-page":"145","DOI":"10.2169\/internalmedicine.45.1460","article-title":"Hepatitis B-related polyarteritis nodosa presenting necrotizing vasculitis in the hepatobiliary system successfully treated with lamivudine, plasmapheresis and glucocorticoid","volume":"45","author":"Takeshita","year":"2006","journal-title":"Intern Med"},{"key":"R13-2-20240830","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1007\/s100670170050","article-title":"Life-threatening complications of hepatitis B virus-related polyarteritis nodosa developing despite interferon-alpha2b therapy: Successful treatment with a combination of interferon, lamivudine, plasma exchanges and steroids","volume":"20","author":"Del\u00e9aval","year":"2001","journal-title":"Clin Rheumatol"},{"key":"R14-2-20240830","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1002\/art.20401","article-title":"Short-term corticosteroids then lamivudine and plasma exchanges to treat hepatitis B virus-related polyarteritis nodosa","volume":"51","author":"Guillevin","year":"2004","journal-title":"Arthritis Rheum"},{"key":"R15-2-20240830","first-page":"292","article-title":"Systemic vasculitis in a district general hospital 1972-1980: Clinical and laboratory features, classification and prognosis of 80 cases","volume":"51","author":"Scott","year":"1982","journal-title":"Q J Med"},{"key":"R16-2-20240830","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jceh.2013.06.001","article-title":"Hepatotropic viral infection associated systemic vasculitides-hepatitis B virus associated polyarteritis nodosa and hepatitis C virus associated cryoglobulinemic vasculitis","volume":"3","author":"Sharma","year":"2013","journal-title":"J Clin Exp Hepatol"},{"key":"R17-2-20240830","doi-asserted-by":"crossref","first-page":"S338","DOI":"10.1046\/j.1440-1746.17.s3.24.x","article-title":"Combination and newer therapies for chronic hepatitis B","volume":"17","author":"Schalm","year":"2002","journal-title":"J Gastroenterol Hepatol"},{"key":"R18-2-20240830","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/0955-3886(96)00013-6","article-title":"Indications for plasma exchange in the treatment of polyarteritis nodosa, Churg-Strauss syndrome and other systemic vasculitides","volume":"17","author":"Lhote","year":"1996","journal-title":"Trans Sci"},{"key":"R19-2-20240830","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/01.md.0000180792.80212.5e","article-title":"Hepatitis B virus-associated polyarteritis nodosa: Clinical characteristics, outcome, and impact of treatment in 115 patients","volume":"84","author":"Guillevin","year":"2005","journal-title":"Medicine (Baltimore"},{"key":"R20-2-20240830","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1046\/j.1526-0968.2003.00036.x","article-title":"Indications of plasma exchanges for systemic vasculitides","volume":"7","author":"Guillevin","year":"2003","journal-title":"Ther Apher Dial"},{"key":"R21-2-20240830","doi-asserted-by":"crossref","first-page":"828","DOI":"10.5005\/jp-journals-10071-23889","article-title":"Therapeutic plasma exchange: A lifesaving therapy in case of ANCA-associated vasculitis with diffuse alveolar hemorrhage","volume":"25","author":"Tripathi","year":"2021","journal-title":"Indian J Crit Care Med"}],"container-title":["Asian Journal of Transfusion Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_70_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:14:58Z","timestamp":1787757298000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ajts.ajts_70_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ajts.ajts_70_22","relation":{},"ISSN":["0973-6247"],"issn-type":[{"value":"0973-6247","type":"print"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}