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[Cutaneous panarteritis nodosa with destructive arthritis]
A Alonso Ruiz1, M Calabozo Raluy, P Manrique Martínez
1Sección de Reumatología, Hospital de Cruces, Baracaldo.
Medicina Clinica
|January 27, 1990
Summary
This study presents a rare case of cutaneous polyarteritis nodosa (CPAN) with destructive arthritis, linked to prior hepatitis B virus infection. It highlights a unique presentation of this vasculitis affecting the joints.
Area of Science:
- Rheumatology
- Dermatology
- Infectious Diseases
Background:
- Cutaneous polyarteritis nodosa (CPAN) is a systemic vasculitis characterized by necrotizing inflammation of medium-sized arteries.
- The association between CPAN and arthritis remains controversial, with limited documented cases and varying degrees of joint involvement.
Observation:
- A 52-year-old male presented with chronic, destructive arthritis of both knees and palpable purpura on the feet.
- Histopathological examination revealed necrotizing arteritis.
- The patient had positive serological markers for previous hepatitis B virus infection (antiHBc and antiHBs antibodies).
- No evidence of systemic vasculitic involvement was detected.
Findings:
- This case represents the first documented instance of CPAN with destructive arthritis in a patient with serological evidence of prior hepatitis B virus infection.
- Review of literature identified 11 cases of CPAN with arthritis, of which only four were well-documented, and just one exhibited joint erosions.
Implications:
- This report expands the understanding of potential triggers and clinical manifestations of CPAN.
- It suggests a possible link between hepatitis B virus infection and the development of destructive arthritis in CPAN.
- Further research is warranted to elucidate the immunopathogenesis and clinical spectrum of CPAN, particularly its association with viral infections and joint disease.