A 35 year old man presents to his doctor with loss of appetite, nausea and vomiting, and fatigue. Laboratory examination confirms the diagnosis of hepatitis B, and the man becomes icteric 2 weeks later. This patient may also be paicularly vulnerable to the development of which of the following disorders?
Thiy percent of patients with polyaeritis nodosa have hepatitis B antigenemia. Polyaeritis is a systemic necrotizing vasculitis that can be difficult to diagnose, since the vascular involvement is typically widely scattered, and the specific symptoms depend on the specific vessels (small- to medium-sized aeries) involved. Patients typically present with low-grade fever, weakness, and weight loss. Abdominal pain, hematuria, renal failure, hypeension, and leukocytosis may occur. The disease is frequently fatal if untreated. Berry aneurysms are congenital saccular dilatations of vessels associated with adult polycystic kidney disease. Coronary aery aneurysms are associated with Kawasaki's disease in children. Dissecting aneurysms are associated with cystic medial necrosis (seen in Marfan's syndrome) and hypeension. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 9. Vascular Pathology. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture.
Berry aneurysm
Coronary aery aneurysm
Dissecting aneurysm
Polyaeritis nodosa