Marked increase of serum hepatitis C virus (HCV) RNA titer during treatment with high-dose prednisolone in a case of polymyositis.
A 70-year-old Japanese woman with hepatitis C virus (HCV) infection was diagnosed with polymyositis and treated with high-dose prednisolone (PSL). The serum alanine aminotransferase (ALT) level increased from 78 to 345 U/l 1 week after initiating treatment, although the polymyositis settled promptly. Furthermore, the serum HCV RNA level increased markedly from 110 to 850 kIU/ml 3 weeks after starting treatment. Previously, the patient had suffered an occlusion of the left branch of the retinal vein secondary to hyperviscosity syndrome resulting from Sjögren's syndrome and low-dose PSL treatment had been commenced. The serum HCV RNA and transaminase levels had not increased during this low-dose PSL treatment. Although intensive immunosuppression is necessary as an initial treatment of several collagen diseases including polymyositis, high-dose PSL therapy may markedly augment the serum HCV RNA level and therefore careful observation is necessary in HCV-infected patients.
Kato
Takashi
T
Division of Internal Medicine, Kawakita General Hospital, 1-7-3, Asagayakita, Suginami-ku, Tokyo, 166-8588, Japan. kintarou@s9.dion.ne.jp
Okai
Takahiro
T
Shiroma
Takuya
T
Fukuda
Junko
J
Yokohari
Ryuichi
R
Tadokoro
Masao
M
D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D016174:Hepacivirus / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000821:virology*; D006801:Humans; D017285:Polymyositis / Q000150:complications / Q000188:drug therapy*; D011239:Prednisolone / Q000009:adverse effects*; D012367:RNA, Viral / Q000097:blood
D005938:Glucocorticoids; D012367:RNA, Viral; D011239:Prednisolone