A 48-year-old man presents with weight loss, abdominal pain, hypertension, and mononeuritis multiplex. He has elevated transaminases. Renal arteriography reveals multiple microaneurysms giving a string of pearls appearance. Which serological marker is classically associated with this condition?
- A Hepatitis C antibody with mixed cryoglobulinemia
- B Anti-proteinase 3 cytoplasmic ANCA
- C Hepatitis B surface antigen ✓
- D Antiphospholipid antibodies with prolonged APTT
Correct answer: C. Hepatitis B surface antigen
Explanation
Polyarteritis nodosa is linked to hepatitis B virus infection in roughly 30 percent of cases; immune complexes deposit in medium-sized muscular arteries producing segmental fibrinoid necrosis and healing by fibrosis, which weakens the wall and forms the microaneurysms seen on angiography. Hepatitis C is tied to cryoglobulinemic vasculitis, PR3-ANCA to granulomatosis with polyangiitis, and antiphospholipid antibodies to arterial and venous thrombosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.