title: [Case of overwhelming postsplenectomy infection (OPSI) with chronic hepatitis type C during peginterferon/ribavirin combination therapy].
abstract: A 61-year-old woman with a past history of splenectomy was admitted to our hospital because of high fever and loss of consciousness during interferon therapy for the treatment of chronic hepatitis type C. She died of multiple organ failure, and disseminated intravascular coagulation shortly after admission. The results of blood culture and the autopsy revealed sepsis due to streptcoccus pneumonia. The neutropenia and immunosuppression by interferon therapy induced overwhelming postsplenectomy infection (OPSI), a potentially rapidly fatal septicemia. When we perform treatment with immunosuppression such as interferon therapy or anticancer drug therapy to splenectomised patients, it is necessary to carry out pnemococcus vaccination. Splenectomy is performed for patients with thrombocytopenia of chronic hepatitis type C before interferon therapy. To avoid OPSI, partial splenic arterial embolization was discussed.
authors.affiliation: Department of Gastroenterology and Hepatology, St. Mary's Hospital, Japan. okamura-88@mx71.tiki.ne.jp
authors.forename: Shusuke
authors.initials: S
authors.lastname: Okamura
authors.forename: Terufumi
authors.initials: T
authors.lastname: Sakai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sumie
authors.forename: Kozaburou
authors.initials: K
authors.lastname: Narita
authors.forename: Taku
authors.initials: T
authors.lastname: Karashima
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Maeyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Higaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ide
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D011008:Pneumococcal Infections / Q000209:etiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*; D018805:Sepsis / Q000209:etiology* / Q000517:prevention & control; D013156:Splenectomy
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D022242:Pneumococcal Vaccines; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a