Hepatitis B Antigen-Associated Periarteritis Nodosa With Prostatic Vasculitis

Abstract

The association of hepatitis B antigenemia with periarteritis nodosa (PAN) has been well described in the past decade 1,2 and is probably caused by circulating immune complexes involving hepatitis B surface antigen (HBsAg). 3 We describe a patient with prostatic vasculitis, a rather unusual presentation for PAN and one that is amenable to diagnosis by needle biopsy. REPORT OF A CASE A 55-year-old white man went to his physician with a six-week history of arthralgias, fatigue, and morning stiffness. He also complained of nocturia. A 2+ enlarged, irregular prostate was noted. Abnormal findings on laboratory studies included an SGOT level of 258 mU/mL (normal, 7 to 40 mU/mL) and an alkaline phosphatase level of 123 mU/mL (normal, 30 to 115 mU/mL). Radioimmunoassay for HBsAg was positive initially and remained positive three months later, at which time testing for hepatitis B antibody was negative. An initial diagnosis of anicteric hepatitis was