[Case of overwhelming postsplenectomy infection (OPSI) with chronic hepatitis type C during peginterferon/ribavirin combination therapy].
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.
Okamura
Shusuke
S
Department of Gastroenterology and Hepatology, St. Mary's Hospital, Japan. okamura-88@mx71.tiki.ne.jp
Sakai
Terufumi
T
Yoshikai
Hiroshi
H
Sumie
Hiroaki
H
Narita
Kozaburou
K
Karashima
Taku
T
Maeyama
Yasuhiko
Y
Higaki
Koichi
K
Ide
Tatsuya
T
Sata
Michio
M
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
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