Sustained response to combination therapy in a patient with chronic hepatitis C and thrombocytopenia secondary to alpha-interferon
| Autor: | Jaime Rebollo, Manuel Jimenez-Saenz, Juan Manuel Herrerias-Esteban, Angel Piñar, María Rojas, Isabel Carmona, Juan Manuel Herrerías-Gutiérrez, Ernesto Salas |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Combination therapy Hepatitis C virus Alpha interferon Interferon alpha-2 medicine.disease_cause Antiviral Agents chemistry.chemical_compound Liver disease Ribavirin Medicine Humans Interferon alfa Hepatology business.industry Gastroenterology Interferon-alpha Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease Thrombocytopenic purpura Combined Modality Therapy Thrombocytopenia Recombinant Proteins chemistry Immunoglobulin G Immunology Prednisone business medicine.drug |
| Zdroj: | Journal of gastroenterology and hepatology. 15(5) |
| ISSN: | 0815-9319 |
| Popis: | Recent data suggest that hepatitis C viral (HCV) infection may induce a significant autoimmune reaction to platelets, but the mechanism is unknown. Many patients with chronic hepatitis C, in fact, have high levels of platelet-associated immunoglobulin G (PAIgG) and HCV-RNA is present in the platelets of 100% of those patients with thrombocytopenia and high PAIgG levels. Hepatitis C virus infection has been associated with the development of thrombocytopenic purpura, sometimes triggered during interferon (IFN) therapy. In such cases, the treatment of the underlying disease is a difficult problem to solve. We report the case of a patient with chronic hepatitis C, who developed life-threatening thrombocytopenic purpura after a prolonged course of IFN-alpha2b over a 4-year period. Treatment with anti-immunoglobulin gammaglobulin (Polyglobin; Quimica Farmaceutica Bayer, Barcelona, Spain) had a transient effect on the platelet count, but prolonged therapy with prednisone was necessary for definitive relief of the haematological complication. Two years later, the patient was treated with combined therapy, including ribavirin (1200 mg/day) and IFN-alpha2b (5 mU, t.i.w.) for 12 months. This therapy induced a sustained response, both biochemical and virological, without haematological complications. This observation suggests that ribavirin may be of benefit in the treatment of immune-mediated thrombocytopenia in patients with chronic hepatitis C, preventing the harmful effect of IFN-alpha but also allowing both drugs to be combined so as to increase the probability of sustained remission of the liver disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text