Hypertension in the liver clinic-polyarteritis nodosa in a patient with hepatitis B

作     者：Shalini Thapar Laroia Suman Lata 

作者机构：Department of Radiology Institute of Liver and Biliary Sciences Department of Nephrology Institute of Liver and Biliary Sciences 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2016年第4卷第3期

页      面：94-98页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Hepatitis B Polyarteritis nodosa Hypertension Liver Extra-hepatic Vascular 

摘      要：Chronic hepatitis caused by hepatitis B virus(HBV) is an endemic disease in India. It is associated with extrahepatic manifestations like polyarteritis nodosa(PAN) which is a vasculitis like disorder, presenting in subacute or chronic phase; involving visceral and systemic vessels. It should always be considered as a possible etiology of hypertension in an underlying setting of hepatitis B. We describe a 56-year-male patient with a history of chronic HBV who presented to the outpatient clinic with history of recent onset hypertension and suspected liver disease. Further work up for the cause of recent hypertension included a contrast computerized tomography of abdomen, which revealed concomitant pathologies of chronic liver disease and multiple aneurysms in bilateral kidneys. This case illustrates the unusual presentation of extrahepatic manifestation of viral hepatitis in the form of PAN of kidneys. PAN as an independent entity may be missed in specialized clinics evaluating liver pathologies, due to its insidious onset, atypical clinical symptoms and multi-systemic manifestations. The knowledge of extrahepatic, renal and vascular manifestations of hepatitis B unrelated to liver disease should be considered by physicians at the time of diagnosis and management of patients with HBV.