[Therapy with peginterferon alfa in a patient with polyneuropathy caused by hepatitis C-associated vasculitis].
BACKGROUND
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.


METHODS
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]).


CONCLUSIONS
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.
Zoras
Constantin
C
dr.zoras@hansemedizin.de
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008111:Liver Function Tests; D009443:Neuritis / Q000188:drug therapy*; D009460:Neurologic Examination / Q000187:drug effects; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D014657:Vasculitis / Q000150:complications / Q000188:drug therapy*
D000998:Antiviral Agents; D018836:Inflammation Mediators; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a