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Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report

BACKGROUND: Hepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP). While its incidence has been largely described during chronic HCV infection, only one case of ITP secondary to acute HCV infection has been reported at this time. CASE PRESENTATION: We rep...

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Autores principales: Alcazer, Vincent, Miailhes, Patrick, Ramière, Christophe, Charre, Caroline, Cotte, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300032/
https://www.ncbi.nlm.nih.gov/pubmed/30567495
http://dx.doi.org/10.1186/s12879-018-3597-4
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author Alcazer, Vincent
Miailhes, Patrick
Ramière, Christophe
Charre, Caroline
Cotte, Laurent
author_facet Alcazer, Vincent
Miailhes, Patrick
Ramière, Christophe
Charre, Caroline
Cotte, Laurent
author_sort Alcazer, Vincent
collection PubMed
description BACKGROUND: Hepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP). While its incidence has been largely described during chronic HCV infection, only one case of ITP secondary to acute HCV infection has been reported at this time. CASE PRESENTATION: We report herein the case of severe ITP secondary to an acute HCV genotype 1a reinfection in a human immunodeficiency virus (HIV)-negative man having sex with men who had been cured several years before of a previous acute genotype 4d HCV infection. After an unsuccessful standard therapy with two courses of intravenous immunoglobulin (at 1 g/kg daily for 2 days) associated with methylprednisolone 1 mg/kg daily, antiviral treatment with sofosbuvir-ledipasvir rapidly achieved virological response and normalised the platelet count. CONCLUSIONS: As a direct effect of HCV on megakaryocytes could be the predominant cause of ITP during acute infection, early antiviral treatment may be beneficial in this case. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3597-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-63000322018-12-20 Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report Alcazer, Vincent Miailhes, Patrick Ramière, Christophe Charre, Caroline Cotte, Laurent BMC Infect Dis Case Report BACKGROUND: Hepatitis C virus (HCV) infection is a recognised cause of secondary immune thrombocytopenia (ITP). While its incidence has been largely described during chronic HCV infection, only one case of ITP secondary to acute HCV infection has been reported at this time. CASE PRESENTATION: We report herein the case of severe ITP secondary to an acute HCV genotype 1a reinfection in a human immunodeficiency virus (HIV)-negative man having sex with men who had been cured several years before of a previous acute genotype 4d HCV infection. After an unsuccessful standard therapy with two courses of intravenous immunoglobulin (at 1 g/kg daily for 2 days) associated with methylprednisolone 1 mg/kg daily, antiviral treatment with sofosbuvir-ledipasvir rapidly achieved virological response and normalised the platelet count. CONCLUSIONS: As a direct effect of HCV on megakaryocytes could be the predominant cause of ITP during acute infection, early antiviral treatment may be beneficial in this case. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3597-4) contains supplementary material, which is available to authorized users. BioMed Central 2018-12-19 /pmc/articles/PMC6300032/ /pubmed/30567495 http://dx.doi.org/10.1186/s12879-018-3597-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Alcazer, Vincent
Miailhes, Patrick
Ramière, Christophe
Charre, Caroline
Cotte, Laurent
Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title_full Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title_fullStr Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title_full_unstemmed Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title_short Early sofosbuvir-ledipasvir treatment for acute HCV infection induced severe immune thrombocytopenia – a case report
title_sort early sofosbuvir-ledipasvir treatment for acute hcv infection induced severe immune thrombocytopenia – a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300032/
https://www.ncbi.nlm.nih.gov/pubmed/30567495
http://dx.doi.org/10.1186/s12879-018-3597-4
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