Which disorder has a high association with Hepatitis B and aneurysms?

• A. Granulomatosis with polyangiitis
• B. Polyarteritis Nodosa
• C. Henoch-Schonlein Purpura
• D. Kawasaki Syndrome

Answer: (B)

Polyarteritis Nodosa is the best answer. It’s a necrotizing vasculitis of medium-sized arteries that classically has a strong association with Hepatitis B infection. In HBV-associated PAN, immune complexes formed from hepatitis B surface antigen and antibodies deposit in vessel walls, triggering inflammation and fibrinoid necrosis of the arterial wall. This process weakens the vessel, leading to the formation of microaneurysms, especially in renal and mesenteric arteries, which explains the abdominal pain, hypertension, and renal symptoms you can see with this disease.

Other vasculitides mentioned involve different vessel sizes or organ patterns and don’t have the same HBV link or propensity for aneurysms. For example, granulomatosis with polyangiitis is ANCA-associated with upper airway and lung involvement; Henoch-Schönlein purpura is a small-vessel IgA vasculitis with palpable purpura and GI symptoms; Kawasaki disease is a pediatric medium-vessel vasculitis that can cause coronary aneurysms but isn’t tied to Hepatitis B.