Related Experiment Videos
[Alithiasic cholecystitis and viral hepatitis B disclosing periarteritis nodosa]
D Sautereau1, F Cessot, A Gainant
1Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Limoges.
Insights
A rare case links acute gallbladder inflammation (cholecystitis) and hepatitis B to a vasculitis called periarteritis nodosa. Steroid treatment rapidly resolved symptoms, indicating its effectiveness in managing this specific presentation.
Area of Science:
- Hepatology
- Gastroenterology
- Rheumatology
Background:
- Acute alithiasic cholecystitis is gallbladder inflammation without gallstones.
- Hepatitis B virus (HBV) infection can have diverse extrahepatic manifestations.
- Periarteritis nodosa is a systemic vasculitis affecting medium-sized arteries.
Observation:
- A patient presented with acute alithiasic cholecystitis and concurrent viral B hepatitis.
- The patient subsequently revealed signs consistent with periarteritis nodosa.
- Histopathology confirmed focal arteritis in the gallbladder and liver.
Findings:
- Viral DNA was negative in serum, and hepatic necrosis was absent.
- The patient received steroid therapy as the primary treatment.
- Rapid regression of vasculitis signs and hepatitis markers was observed.
Implications:
- This case highlights an unusual association between HBV, cholecystitis, and periarteritis nodosa.
- Steroid therapy appears effective for managing this specific clinical presentation.
- Further research may elucidate the pathogenetic links between viral hepatitis and systemic vasculitis.
Abstract:
The authors report the case of a patient with acute alithiasic cholecystitis associated with viral B hepatitis revealing periarteritis nodosa. Histopathological results showed signs of focal arteritis in the gallbladder and liver. Because of the negativity of the viral DNA in serum and the lack of histopathological necrosis in hepatic specimen, the patient was treated by steroid therapy only with a rapid regression of signs of vasculitis and the disappearance of the hepatitis markers.