RESUMO
BACKGROUND AND AIMS: The early onset of cardio-metabolic abnormalities, known as metabolically unhealthy (MU) status, is highly associated with obesity and cardiovascular disease (CVD), as well as with increased morbidity and mortality later in life. Given the lack of a consensus MU classification for prepubertal children, we aimed to compare available MU definitions in terms of their association with CVD risk biomarkers. METHODS AND RESULTS: A total of 930 prepubertal children (622 with overweight/obesity, 462 males) aged 5-10.9 years were recruited, anthropometric measures were taken and biomarkers were analyzed. Children were classified using eight MU definitions based on different cut-offs for blood pressure, triacylglycerides, high-density lipoprotein cholesterol, glucose and homeostasis model assessment for insulin resistance (HOMA-IR). MU prevalence in children with overweight/obesity ranged between 30% and 60% across definitions. Plasma concentrations of resistin, leptin, myeloperoxidase (MPO) and total plasminogen activator inhibitor 1 (tPAI-1) were higher, and those of adiponectin were lower, in MU compared to MH children with overweight/obesity. Linear regression analyses confirmed the contribution of MPO and tPAI-1 concentrations to MU status, with most significant results derived from definitions that use age and sex-specific criteria and that account for HOMA-IR. CONCLUSION: Plasma concentrations of MPO and tPAI-1 are increased in prepubertal MU children irrespective of having normal-weight or overweight/obesity. Inclusion of age and sex-specific cut-offs for cardio-metabolic components as well as insulin resistance criteria increases the quality of MU definitions as seen by their stronger association with CVD biomarkers concentrations.
Assuntos
Doenças Cardiovasculares/sangue , Nível de Saúde , Síndrome Metabólica/sangue , Obesidade Infantil/sangue , Peroxidase/sangue , Inibidor 1 de Ativador de Plasminogênio/sangue , Terminologia como Assunto , Fatores Etários , Biomarcadores/sangue , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Resistência à Insulina , Masculino , Síndrome Metabólica/classificação , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Obesidade Infantil/classificação , Obesidade Infantil/diagnóstico , Obesidade Infantil/epidemiologia , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologiaRESUMO
PURPOSE: Uroguanylin (UGN) is a 16 amino acid peptide produced mainly by intestinal epithelial cells. Nutrients intake increases circulating levels of prouroguanylin that is processed and converted to UGN to activate the guanylyl cyclase 2C receptor (GUCY2C). Given that the UGN-GUCY2C system has been proposed as a novel gut-brain endocrine axis regulating energy balance, the aim of the present study was to investigate the regulation of UGN protein levels in duodenum and circulating levels in lean and obese mice under different nutritional conditions and its potential interaction with leptin. METHODS: Swiss, C57BL/6 wild-type and ob/ob male adult mice under different nutritional conditions were used: fed ad libitum standard diet (control); 48 h fasting (fasted); 48 h fasting followed by 24 h of feeding (refed); and fed high-fat diet (45 %) during 10 weeks. In addition, peripheral leptin administration was performed. Intestinal uroguanylin expression was studied by Western blot analysis; plasma levels were measured by ELISA. RESULTS: Food deprivation significantly reduced plasma UGN levels, which were correlated with the lower protein levels of UGN in duodenum. These effects were reverted after refeeding and leptin challenge. Consistently, in ob/ob mice UGN expression was decreased, whereas leptin treatment up-regulated UGN levels in duodenum in these genetically modified mice compared to WT. Diet-induced obese mice displayed increased UGN levels in intestine and plasma in comparison with lean mice. CONCLUSIONS: Our findings suggest that UGN levels are correlated with energy balance status and that the regulation of UGN by nutritional status is leptin-dependent.
Assuntos
Mucosa Intestinal/metabolismo , Leptina/farmacologia , Peptídeos Natriuréticos/sangue , Estado Nutricional , Animais , Dieta Hiperlipídica , Metabolismo Energético , Leptina/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Peptídeos Natriuréticos/genética , Regulação para CimaRESUMO
The prevalence of overweight and obesity in most developed countries has markedly increased during the last decades. In addition to genetic, hormonal, and metabolic influences, environmental factors like fetal and neonatal nutrition play key roles in the development of obesity. Interestingly, overweight during critical developmental periods of fetal and/or neonatal life has been demonstrated to increase the risk of obesity throughout juvenile life into adulthood. In spite of this evidence, the specific mechanisms underlying this fetal/neonatal programming are not perfectly understood. However, it is clear that circulating hormones such as insulin and leptin play a critical role in the development and programming of hypothalamic circuits regulating energy balance. Here, we review what is currently known about the impact of perinatal malnutrition on the mechanisms regulating body weight homeostasis. Understanding these molecular mechanisms may provide new targets for the treatment of obesity.
Assuntos
Metabolismo Energético , Hipotálamo/metabolismo , Hipotálamo/fisiopatologia , Transtornos da Nutrição do Lactente/metabolismo , Transtornos da Nutrição do Lactente/fisiopatologia , Obesidade/metabolismo , Obesidade/fisiopatologia , Adulto , Animais , Feminino , Humanos , Hipotálamo/patologia , Lactente , Transtornos da Nutrição do Lactente/complicações , Transtornos da Nutrição do Lactente/patologia , Recém-Nascido , Masculino , Obesidade/etiologia , Obesidade/patologiaRESUMO
Changes in paraoxonase 1 (PON1) activities have been observed in a variety of diseases involving oxidative stress, such as CVD. However, its role in obesity has not been fully established. In the present study, we aimed (1) to genotype sixteen PON1 SNP, (2) to measure serum PON1 activities and (3) to correlate these findings with the incidence of childhood obesity and related traits. We conducted a case-control study of 189 normal-weight and 179 obese prepubertal children, and we measured four different PON1 activities: lactonase; paraoxonase; arylesterase; diazoxonase. Although none of these activities was significantly different between the obese and normal-weight children, lactonase activity was found to be positively correlated with HDL-cholesterol and ApoA1 levels and negatively correlated with myeloperoxidase and fatty acid-binding protein 4 levels. Among the sixteen genotyped PON1 SNP, only the intronic SNP rs854566 exhibited a significant association with obesity (OR 0·61, 95 % CI 0·41, 0·91; P= 0·016). This genetic variant was also associated with increased diazoxonase, lactonase and arylesterase activities and decreased paraoxonase activity. Other genetic variants exhibited different association patterns with serum activities based on their location within the PON1 gene, and SNP that were located within the promoter were strongly associated with lactonase, arylesterase and diazoxonase activities. The functional variant Q192R exhibited the greatest effect on paraoxonase activity (P= 5·88 × 10(-42)). In conclusion, SNP rs854566 was negatively associated with childhood obesity and with increased serum PON1 activities in prepubertal children. We determined that lactonase is a reliable indicator of PON1 activities and should be included in future studies of PON1 function.
Assuntos
Arildialquilfosfatase/genética , Hidrolases de Éster Carboxílico/sangue , Genótipo , Obesidade Infantil/genética , Polimorfismo de Nucleotídeo Único , Apolipoproteína A-I/sangue , Arildialquilfosfatase/sangue , Estudos de Casos e Controles , Criança , HDL-Colesterol/sangue , Proteínas de Ligação a Ácido Graxo/sangue , Feminino , Humanos , Masculino , Razão de Chances , Obesidade Infantil/enzimologia , Obesidade Infantil/metabolismo , Peroxidase/sangue , Regiões Promotoras GenéticasRESUMO
BACKGROUND: The 11ß-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) enzyme catalyses the regeneration of active cortisol from inert cortisone and plays a critical role in tissue-specific corticosteroid reactions; therefore, 11ß-HSD1 is a key molecule associated with the development of obesity. Despite evidence for its role in obesity, no genetic polymorphisms have been significantly associated with the disease per se. OBJECTIVE: The aim of this study was to evaluate whether HSD11B1 gene variants, which have never been studied before, are associated with obesity and its related traits, as well as its relation to biomarkers of inflammation, liver damage and cardiovascular disease in a cohort of Spanish children. DESIGN: We performed a prospective case-control study. SUBJECTS: A total of 534 children were examined and classified as being obese (n=292) or normal weight (n=242). Anthropometric and biochemical measurements related to obesity, including inflammation, liver damage and cardiovascular disease, were determined. Genomic DNA was extracted and 10 HSD11B1 gene single-nucleotide polymorphisms (SNPs) were genotyped. RESULTS: A novel SNP, rs3753519, was strongly associated with obesity and this SNP was the only statistically significant HSD11B1 gene SNP remaining after a Bonferroni correction (odds ratio=1.97 for allelic effect, 95% confidence interval 1.23-3.16; P=0.004 and Bonferroni corrected P=0.046). In addition, this SNP was significantly and positively associated with increased body mass index (BMI), BMI z-score, weight, waist circumference, plasma γ-glutamyl transpeptidase and plasma active plasminogen activator inhibitor 1. The SNP was negatively associated with plasma adiponectin and cortisol after adjusting for sex and age. None of the inflammation biomarkers tested were associated with the risk allele. CONCLUSION: These data, which link an HSD11B1 genotype with both disease prevalence and its related phenotypes, strongly support a role for the rs3753519 polymorphism in the pathogenesis of pediatric-onset obesity.
Assuntos
11-beta-Hidroxiesteroide Desidrogenase Tipo 1/genética , Obesidade/genética , Polimorfismo de Nucleotídeo Único , 11-beta-Hidroxiesteroide Desidrogenase Tipo 1/metabolismo , Adolescente , Idade de Início , Biomarcadores/sangue , Composição Corporal/genética , Índice de Massa Corporal , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Estudos de Casos e Controles , Criança , Feminino , Perfilação da Expressão Gênica , Predisposição Genética para Doença , Genótipo , Humanos , Inflamação/sangue , Inflamação/genética , Resistência à Insulina , Fígado/metabolismo , Masculino , Obesidade/epidemiologia , Obesidade/metabolismo , Estudos Prospectivos , Espanha/epidemiologiaRESUMO
BACKGROUND/AIMS: There is a strong debate on the diagnosis and early phenotypic expression of the metabolic syndrome in children. The aim of the present study was to examine the frequency of the metabolic syndrome using various definitions in obese prepubertal and pubertal children. METHODS: 478 (213 females and 265 males) obese children were recruited in three provinces of Spain. Blood pressure (BP), waist circumference, and weight and height were measured, and body mass index was calculated. Glucose, insulin, high-density lipoprotein cholesterol and triacylglycerols were determined. We classified the children according to seven different proposed definitions of the metabolic syndrome. RESULTS: Regardless of the definition used, the prevalence of the metabolic syndrome (8.3-34.2%) was relatively high in obese children in the prepubertal period as well as in pubertal children (9.7-41.2%). We performed a principal-factor analysis to explain correlations among features of the metabolic syndrome and found that glucose metabolism (factor 1), dyslipidemia (factor 2) and obesity/BP (factor 3) explained 72% of the total variance. CONCLUSION: Irrespective of the classification used, the metabolic syndrome is not only present in pubertal but also in prepubertal children. International definitions of the metabolic syndrome should also consider criteria specific for children in the prepubertal period, i.e. children aged <10 years.
Assuntos
Idade de Início , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Obesidade/fisiopatologia , Adolescente , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Guias de Prática Clínica como Assunto , Prevalência , Análise de Componente Principal , Estudos Prospectivos , Puberdade , Caracteres Sexuais , Espanha/epidemiologiaRESUMO
The fibronectin type III domain-containing protein 5 (FNDC5) discovered in 2002 has recently gained attention due to its potential role in protecting against obesity. In rat, no data exist regarding FNDC5 production and regulation in the stomach. The aim of the present work was to determine the expression of FNDC5 in the rat stomach and its potential regulation by body composition. The present data shows FNDC5 gene expression in the gastric mucosa. Immunohistochemical studies found FNDC5 immunopositivity in chief cells of gastric tissue. By the use of three different antibodies FNDC5 was found expressed in gastric mucosa and secreted by the stomach. The rate of gastric FNDC5 secretion parallels the circulating levels of FNDC5. The body fat mass increase after intervention with high fat diet coincided with a decrease in the secretion of FNDC5 from the stomach and a diminution in the FNDC5 circulating levels. In summary, the present data shows, for the first time, the expression of FNDC5 in the stomach of rats and its regulation by body composition, suggesting a potential role of gastric FNDC5 in energy homeostasis.
Assuntos
Composição Corporal/genética , Metabolismo Energético/genética , Fibronectinas/biossíntese , Obesidade/genética , Tecido Adiposo/crescimento & desenvolvimento , Tecido Adiposo/metabolismo , Animais , Fibronectinas/genética , Mucosa Gástrica/crescimento & desenvolvimento , Mucosa Gástrica/metabolismo , Regulação da Expressão Gênica , Humanos , Obesidade/metabolismo , Obesidade/patologia , RatosRESUMO
Prebiotics are non-digestible food ingredients (oligosaccharides) that reach the colon and are used as substrate by microorganisms producing energy, metabolites and micronutrients used for the host; in addition they also stimulate the selective growth of certain beneficial species (mainly bifidobacteria and lactobacilli) in the intestinal microbiota. In this article, a multidisciplinary approach to understand the concept of prebiotic carbohydrates, their properties and beneficial effects in humans has been carried out. Definitions of prebiotics, reported by relevant international organizations and researchers, are described. A comprehensive description of accepted prebiotics having strong scientific evidence of their beneficial properties in humans (inulin-type fructans, FOS, GOS, lactulose and human milk oligosaccharides) is reported. Emerging prebiotics and those which are in the early stages of study have also included in this study. Taken into account that the chemical structure greatly influences carbohydrates prebiotic properties, the analytical techniques used for their analysis and characterization are discussed. In vitro and in vivo models used to evaluate the gastrointestinal digestion, absorption resistance and fermentability in the colon of prebiotics as well as major criteria to design robust intervention trials in humans are described. Finally, a comprehensive summary of the beneficial effects of prebiotics for health at systemic and intestinal levels is reported. The research effort on prebiotics has been intensive in last decades and has demonstrated that a multidisciplinary approach is necessary in order to claim their health benefits.
Los prebióticos son ingredientes alimentarios no digeribles (oligosacáridos) que llegan al colon y sirven de sustrato a los microorganismos, originando energía, metabolitos y micronutrientes utilizados por el hospedador y estimulando el crecimiento selectivo de determinadas especies beneficiosas (principalmente, bifidobacterias y lactobacilos) de la microbiota intestinal. En este artículo se realiza una revisión sobre los carbohidratos prebióticos desde diferentes perspectivas, comenzando por las definiciones de prebióticos formuladas a lo largo de los últimos treinta años por científicos y diferentes organismos internacionales. Se realiza una descripción detallada de los prebióticos aceptados, como tales, que presentan propiedades beneficiosas fundamentadas en estudios llevados a cabo en humanos (fructanos tipo inulina y FOS; GOS, lactulosa y oligosacáridos de leche humana), los que se consideran prebióticos emergentes y aquellos que se encuentran en fases iniciales de estudio. Además y teniendo en cuenta que la estructura química de los carbohidratos influye notablemente en sus propiedades prebióticas, se describen las técnicas más utilizadas para su análisis y caracterización. Asimismo, se detallan los modelos in vitro e in vivo más utilizados para estudiar la resistencia de los prebióticos a la digestión y la absorción gastrointestinal, la fermentación de los prebióticos en el colon así como los criterios a tener en cuenta para llevar a cabo ensayos de intervención en humanos. Por último se realiza una amplia descripción de los efectos beneficiosos de los prebióticos para la salud a nivel intestinal y sistémico. Como conclusión, podría decirse que la investigación existente hasta el momento, sobre prebióticos, es extensa y pone de manifiesto que es necesario considerar un gran número de factores para poder atribuir alegaciones de salud a un prebiótico.
Assuntos
Prebióticos , Carboidratos , Fibras na Dieta , Microbioma Gastrointestinal , Trato Gastrointestinal/microbiologia , Humanos , MicrobiotaRESUMO
The prevalence of obesity has increased worldwide, and approximately 25%-35% of the adult population is obese in some countries. The excess of body fat is associated with adverse health consequences. Considering the limited efficacy of diet and exercise in the current obese population and the use of bariatric surgery only for morbid obesity, it appears that drug therapy is the only available method to address the problem on a large scale. Currently, pharmacological obesity treatment options are limited. However, new antiobesity drugs acting through central nervous system pathways or the peripheral adiposity signals and gastrointestinal tract are under clinical development. One of the most promising approaches is the use of peptides that influence the peripheral satiety signals and brain-gut axis such as GLP-1 analogs. However, considering that any antiobesity drug may affect one or several of the systems that control food intake and energy expenditure, it is unlikely that a single pharmacological agent will be effective as a striking obesity treatment. Thus, future strategies to treat obesity will need to be directed at sustainable weight loss to ensure maximal safety. This strategy will probably require the coadministration of medications that act through different mechanisms.
Assuntos
Fármacos Antiobesidade/farmacologia , Descoberta de Drogas , Obesidade/tratamento farmacológico , Peptídeos/farmacologia , Segurança , Redução de Peso/efeitos dos fármacos , Fármacos Antiobesidade/química , Fármacos Antiobesidade/uso terapêutico , Peptídeos/química , Peptídeos/uso terapêuticoRESUMO
BACKGROUND: The factors relevant to the prognosis of childhood asthma differ from one population to another. OBJECTIVES: To characterize the course of childhood asthma in the catchment area of our hospital, and to identify prognostic factors for this population. METHODS: All children given a diagnosis of asthma in the paediatric pulmonology service of a tertiary hospital were followed up for 5 years. RESULTS: Satisfactory control of asthma was achieved in 69 % of cases. The factors identified as associated with poor control were allergy to cats and pollen, a large number of crises in the year prior to diagnosis, and younger age at onset. CONCLUSIONS: In our region, childhood asthma has a relatively favourable prognosis. The subsequent course of the disease appears to be determined in childhood. The persistence of symptoms appears to depend to a significant extent on the degree of atopy.
Assuntos
Asma/etiologia , Adolescente , Idade de Início , Asma/diagnóstico , Asma/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pico do Fluxo Expiratório/imunologia , Valor Preditivo dos Testes , Prognóstico , Rinite Alérgica Sazonal/complicações , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Fatores de Risco , População Rural , Índice de Gravidade de Doença , Testes Cutâneos , Espanha , População UrbanaRESUMO
A report is given about a seldom coincidence of Ehlers-Danlos-Syndrome, diabetes mellitus and pregnancy in a 31 year old patient.--The course of pregnancy was uncomplicated except a cervical insufficiency and a secondary wound healing of the episiotomy. The exact diagnosis of the Ehlers-Danlos-syndrome should be done already before pregnancy.
Assuntos
Síndrome de Ehlers-Danlos/complicações , Complicações na Gravidez/diagnóstico , Gravidez em Diabéticas/complicações , Adulto , Síndrome de Ehlers-Danlos/diagnóstico , Feminino , Humanos , Recém-Nascido , Insulina/uso terapêutico , Masculino , Trabalho de Parto Prematuro/prevenção & controle , Gravidez , Gravidez em Diabéticas/diagnóstico , CicatrizaçãoRESUMO
To measure the effect of intergroup transfer, four cows were added to a group of 20 cows at 28-day intervals in five trials. The two groups of cows were housed in adjoining lots and fed identical rations from opposite sides of a feed bunk which provided .9 m linear feeding space per cow. Means of the number of agonistic encounters per transferred cow were 9.4, 4.4, 4.3, 3.8, 3.3, and 2.6 during the 1-h period immediately following the first feeding on days 1, 2, 7, 14, 21, and 28. The average dominance values of the transferred cows during the 28 days (.19, .14, and .32) showed no perceptible trend, and mean body weight (567, 569, and 571 kg) was not limited. On day 1 the mean 4% fat-corrected milk yield of the transferred cows decreased .51 kg or 3%, and nontransferred cows increased .01 kg. The decrease in milk yield of the transferred cows was not associated with number of agonistic encounters per se. After day 1 regrouping had no effect on milk yield.
Assuntos
Agressão , Comportamento Agonístico , Comportamento Animal , Bovinos/fisiologia , Lactação , Animais , Peso Corporal , Feminino , Humanos , Gravidez , Predomínio Social , Meio Social , Especificidade da EspécieRESUMO
BACKGROUND: The aim of the current study was to evaluate the prevalence of lactose malabsorption (LM) in Galicia (NW Spain) in order to design nutritional intervention and/or public education strategies for high risk groups. METHODS: We conducted a study of LM by breath-hydrogen carbohydrate absorption test (BH2 test) in 850 healthy subjects. All subjects underwent BH2 tests following ingestion of a aqueous solution of 2 g lactose/kg body weight up to a maximum of 50 g. Subjects with LM were retested after ingesting 250 ml of milk and/or 250 ml of yogurt. RESULTS: The frequency of LM in the subjects who ingested 2 g lactose/kg body weight was 32.5%. This percentage decreased significantly with a decrease in the quantity of administered lactose and the vehicle was milk or yogurt-only 13.7% was LM after 250 ml of milk and 3.8% after 250 ml of yogurt. Gastrointestinal symptoms also depend on dosage of lactose and vehicle, decreasing from 54.3% after 2 g lactose/kg to 18.5% after milk and to 0% after yogurt. The frequency and number of gastrointestinal symptoms were significantly higher (p < 0.001) in LM than in lactose absorption (LA). CONCLUSIONS: Lactose malabsorption is prevalent in the population of Galicia. An important number of subjects identified as LM with usual clinical testing become LA when the ingestion of dairy products is limited so that the amount of lactose consumed is similar to that contained in a usual serving. Our results suggest the importance of BH2 testing following ingestion of usual consumed amounts of lactose per serving.
Assuntos
Intolerância à Lactose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Feminino , Humanos , Intolerância à Lactose/fisiopatologia , Masculino , Pessoa de Meia-Idade , Leite , Espanha , IogurteRESUMO
We studied serum levels of total cholesterol, lipoproteins and triglycerides in venous blood samples and the intake of nutrients using the subject's daily record of food eaten during a period of 7 d. The material comprised 7367 children and adolescents. The overall average lipid levels (4.55 +/- 0.91 mmol/L for TC, 1.42 +/- 0.47 mmol/L for HDL-C, 2.74 +/- 0.96 mmol/L for LDL-C) are high and similar to those found in other regions of Spain in the 1990s. The proportion of children with TC > or = 5.17 mmol/L (200 mg/dl) was 19%; that of children with HDL-C < or = 0.91 mmol/L (35 mg/dL) 6.5%. There is a striking and statistically significant difference between the proportions of boys and girls aged 15-20 y who have HDL-C levels in this range (15.8% for boys and only 4.2% for girls). We also demonstrate a high total fat (44% of TCV), saturated fat (16% TCV) and cholesterol (387 mg) intake. Because of the elevated fat and saturated fat intake and the increment of a more atherogenic lipid profile in our children, preventive nutritional measures are necessary, and life habits such as physical exercise and actively reducing fat and saturated fat intake have to be applied and inculcated in children from an early age.
Assuntos
Dieta Aterogênica , Lipídeos/sangue , Triglicerídeos/sangue , Adolescente , Adulto , Criança , Pré-Escolar , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Humanos , Masculino , Inquéritos Nutricionais , EspanhaRESUMO
Introducción: la Poliarteritis nodosa (PAN) se define como una vasculitis necrotizante que compromete a las arterias de mediano calibre, y causa un compromiso sistémico. Existe una asociación entre la PAN y la infección por el virus de la Hepatitis B, en relación principalmente con el depósito de inmunocomplejos virales circulantes. Las manifestaciones clínicas son inespecíficas y requiere un alto índice de sospecha. Se han usado varios regímenes de inmunosupresores (corticoides-ciclofosfamida) plasmaféresis y drogas antivirales, con respuestas variables. Objetivo: presentación de un caso clínico de PAN asociado con infección por virus de Hepatitis B, y revisión de la literatura. Caso clínico: paciente masculino de 40 años, con manifestaciones severas de Poliartritis nodosa, asociado con infección por Hepatitis B. Conclusiones: la PAN es una enfermedad poco frecuente, la asociación con infección por Hepatitis B está bien documentada y las estrategias terapéuticas difieren de las de la PAN clásica. Es una patología potencialmente fatal cuando no se reconoce y trata adecuadamente
Backgraound: Polyarteritis nodosa (PAN) is defined by a necrotizing vasculitis of medium sized arteries that causes a systemic inflammatory disease. There is an association between PAN and hepatitis B virus (HBV) infections, related mostly with viral circulting immune complexes. Clinical manifestations are not specific and require a high index of suspicion. Several immunosuppressive regimens (corticoids-ciclophosphamide), plasmapheresis and antiviral drugs have been used with varying response. Objective: Report of a clinical case of PAN associated with Hepatitis B virus infection and review of the literature. Case-reporte: A 40 year old man with severe manifestations of Polyarteritis nodosa, associated with Hepatitis B infection. Conclusions: PAN is uncommon disease, the association with hepatitis B virus infection is well documented, and the treatment strategies differs from the classic PAN. It is a potentially fatal disease when unrecognized and untreated