Lamivudine in the Treatment of Polyarteritis Nodosa Associated with Acute Hepatitis B

To the Editor: There is no consensus on the optimal treatment of polyarteritis nodosa associated with hepatitis B virus (HBV) infection. The potential risk of accelerating viral replication complicates the use of corticosteroids and cytotoxic agents. Benefit from the combined use of plasmapheresis, corticosteroids, and antiviral agents has been reported previously.1 We describe a patient with HBV-associated polyarteritis nodosa who was treated with this approach. A 39-year-old woman was transferred to our hospital in December 1999 for the treatment of vasculitis. In September 1999, she had presented with a diffuse pruritic rash, polyarticular symmetric arthritis, abdominal pain, and constitutional symptoms. . . .