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Revista Cubana de Medicina

versión On-line ISSN 1561-302X


MARTINEZ FERNANDEZ, Liodelvio et al. Fever of unknown origin: Form of polyarteritis nodosa related to chronic hepatitis B virus. Rev cubana med [online]. 2007, vol.46, n.3, pp. 0-0. ISSN 1561-302X.

The case of 60-year-old female patient with a picture of unknown fever   that had been recently operated on of olecranon fracture that made suspect the possibility of fever induced by a foreign body is reported. This possibility was discarded due to the persistance of fever after the removal of the material of metallic osteosynthesis.   In the hemochemical analysis, slightly elevated levels of aminotranspherases were found. The existance of chronic hepatitis B virus was confirmed by laparoscopy, liver biopsy, surface antigenemia and polymerase chain reaction (PCR) of hepatitis B virus (HBV). Due to the confirmation of the positive surface antigen, to the presence of vasculitic lesions, and to the appearance of a multiple mononeuropathy, there was a diagnostic suspicion of PAN, which was corroborated by biopsy of the sural nerve. It was stressed the satisfactory evolution with antiviral interferon treatment and immunosuppressive regime: oral prednisone and cyclophosphamide. It was concluded that PAN-HBV is a frequent association that requires combined treatment to improve the prognosis. Emphasis was made on the need of the diagnostic search of the entity in patients with FUO, mainly if there is an association  with positive hepatitis B antigenemia , vasculitis and mononeuropathy.

Palabras clave : Polyarteritis nodosa; vasculitis; fever of unknown origin; hepatitis B; chronic hepatitis.

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