Work

Microscopic polyangiitis complicated with pulmonary hepatitis B virus infection: A case report and literature review

Year: 2025

Type: article

Abstract: • First reported case of microscopic polyangiitis with hepatitis B virus co-infection. • Metagenomic next-generation sequencing enabled early detection of pulmonary hepatitis B virus infection. • For the first time, we identified a patient with hepatitis B virus localized exclusively in lung tissue while testing negative in peripheral blood. Microscopic polyangiitis (MPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by inflammatory changes in small vessel walls. Its clinical manifestations are nonspecific, and pulmonary involvement often presents as cough and production of sputum, which can be misdiagnosed as pneumonia. However, no cases of MPA coexisting with pulmonary hepatitis B virus (HBV) infection have been reported. This report describes the first such case. A 66-year-old man presented with a productive cough, swelling of the finger joints, and bilateral hearing loss. Initial imaging suggested pulmonary infection or malignancy. MPA was diagnosed based on positive myeloperoxidase-ANCA serology and vasculitic changes on histopathological examination of a lung biopsy specimen. Metagenomic next-generation sequencing of biopsy tissue revealed HBV, confirming a concurrent pulmonary HBV infection. Treatment with methylprednisolone, rituximab, and entecavir resulted in a favorable outcome.

Source: Infectious Medicine

DOI: 10.1016/j.imj.2025.100218

Authors: Ronghuang Liao, Lingling Zhang, Danlan Wang, Ni Tan

Institutions: Sun Yat-sen University, Sun Yat-sen Memorial Hospital, Guangxi Maternal and Child Health Hospital

Language: English

Topic: Vasculitis and related conditions

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500