Granulomatous hepatitis, perihepatic lymphadenopathies, and autoantibody positivity: an unusual association in a child with hepatitis C.
A 10-year-old boy with hepatitis C had granulomatous hepatitis (GH) at initial liver biopsy. He also had enlarged perihepatic lymph nodes and smooth muscle antibody (SMA) positivity. GH is a rare finding in hepatitis C virus (HCV) infection. Our patient is special since GH secondary to HCV infection was associated with both autoantibodies and multiple intraabdominal lymphadenopathies. After interferon (IFN) and ribavirin therapy, HCV RNA became negative, along with the resolution of hepatic granulomas (HG), lymphadenopathies, and SMA positivity. Although early virologic response was not achieved under IFN treatment, the therapy period was extended, contrary to routine practice, and resulted in a delayed response. We conclude that the usage of IFN for longer periods in GH-associated HCV infection might be promising.
Department of Pediatric Gastroenterology, Gazi University School of Medicine, Ankara, Turkey. odulmd2003@yahoo.com
Odul
O
Egritas
Sinan
S
Sari
Buket
B
Dalgic
Cigdem
C
Vural
Gulen
G
Akyol
D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D006099:Granuloma / Q000276:immunology* / Q000821:virology*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008099:Liver / Q000473:pathology / Q000821:virology; D008206:Lymphatic Diseases / Q000276:immunology* / Q000821:virology*; D008297:Male; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use
D000998:Antiviral Agents; D001323:Autoantibodies; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons; D000410:Alanine Transaminase