[Hepatitis-B-associated vasculitis. Clinical course with glucocorticoid and alpha-interferon therapy].
A 31-year-old women with chronic active hepatitis B (HBs antigen-positive, HBe antigen-negative) developed a painful petechia rash on both lower legs and the inner surface of the thighs. Histology of a skin biopsy revealed leucocytoclastic vasculitis. The affected skin areas contained HBs antigen and immunoglobulins. Immunosuppressive treatment with initially 60mg/d prednisolone improved the skin condition but activated the chronic hepatitis, GPT rising up to 240 U/l. The steroid treatment had to be discontinued. Subsequently the transaminases became normal but the vasculitis foci recurred. The patient was therefore given alpha-interferon, three times 5 mill. IU weekly subcutaneously for 6 months. The skin lesions disappeared and the circulating HBV-DNA decreased. But the HBs antigen could not be eliminated. It is to be noted that 12 months after the end of the alpha-interferon treatment the vasculitis has not recurred. - This case and published reports indicate that interferon treatment is effective against HBV-associated and immunoglobulin-complex mediated disease.
Glück
T
T
Abteilung Innere Medizin, Universität Tübingen.
Weber
P
P
Wiedmann
K H
KH
D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology; D006521:Hepatitis, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use*; D014657:Vasculitis / Q000188:drug therapy* / Q000276:immunology / Q000821:virology
D016898:Interferon-alpha; D011239:Prednisolone
Hepatitis-B-assoziierte Vaskulitis. Verlauf unter Therapie mit Glucocorticoiden und alpha-Interferon.