Therapy with peginterferon alfa in a patient with polyneuropathy caused by hepatitis C-associated vasculitis

Medizinische Klinik
Constantin Zoras

Abstract

Liver cirrhosis and hepatocellular carcinoma are typical consequences of chronic hepatitis C. Also other comorbidities, such as polyneuropathy, can be associated with chronic hepatitis C. Therapy of polyneuropathy is controversial, because immunosuppressive therapy can accelerate chronic hepatitis C. Also antiviral therapy of chronic hepatitis C with interferon-alpha can aggravate polyneuropathy. The presented case study describes a patient with vasculitic neuropathy without cryoglobulinemia associated with chronic hepatitis C. The predominant symptom was pain in the lower leg. Despite immunosuppressive therapy with cortisone and methotrexate (MTX), symptoms exacerbated following therapy with cyclophosphamide. Because of further lacking amelioration of symptoms, the patient was treated with peginterferon alfa-2a and ribavirin, which led to prompt marked and persistent amelioration of symptoms. Hepatitis C virus could be eliminated sustainedly (SVR [sustained virological response]). In this case report, causal therapy of chronic hepatitis C with peginterferon alfa-2a and ribavirin has proven to be effective in a patient with hepatitis C-associated polyneuropathy.

Citations

Jan 28, 2009·Journal of Neuroimmunology·Joerg-Patrick Stübgen

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