Generalized peripheral lymphadenopathy in a patient treated for chronic HCV infection.
BACKGROUND
A 62-year-old white woman was admitted to hospital with a 2-month history of progressive, painless, left supraclavicular and axillary lymph node enlargement. The patient's history was significant for chronic HCV infection, for which she had just completed a 48-week course of treatment with pegylated interferon alpha (180 microg once weekly) plus ribavirin (1,000 mg daily). She attained an end-of-treatment response and subsequent qualitative measurement of HCV RNA confirmed a sustained virological response. The onset of progressive painless lymph node enlargement had been noted by the patient during the last 2 weeks of her treatment for HCV.


METHODS
Physical examination, otorhinolaryngological examination, laboratory investigations (including complete blood counts, liver function tests and serological tests), mammography, thyroid and abdominal ultrasound, CT scans, abdominal MRI, upper gastrointestinal endoscopy, colonoscopy, supraclavicular lymph node biopsy, (67)Ga scintigraphy and bronchoalveolar lavage.


METHODS
Granulomatous lymphadenitis of uncertain etiology with sarcoid-type and tuberculoid-type granulomas.


RESULTS
Standard antituberculosis treatment with isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months, followed by isoniazid and rifampicin for 7 months.
Ferreira
Carlos Noronha
CN
Gastroenterology and Hepatology Division, Hospital Santa Maria, Lisbon, Portugal. carlosnferreira@hotmail.com
Barjas
Elidio R
ER
Correia
Luis A
LA
Tavares
Luis
L
Ferreira
Cristina
C
Serejo
Fatima L
FL
de Moura
Miguel Carneiro
MC
Monteiro
Estela
E
D000995:Antitubercular Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D002968:Clavicle; D003937:Diagnosis, Differential; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008198:Lymph Nodes; D008199:Lymphadenitis / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis
D000995:Antitubercular Agents