Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen

Background: Neurosarcoidosis is a rare manifestation of hepatitis C virus (HCV) infection, mainly in patients exposed to interferon-based therapies. Although we are living in a new era of HCV treatment, there is still little data concerning the treatment of extrahepatic complications of the disease...

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Bibliographic Details
Published in:GE Portuguese journal of gastroenterology 2019-07, Vol.26 (4), p.275-278
Main Authors: Lima, Sérgio, Faria, Raquel, Nery, Filipe
Format: Article
Language:English
Subjects:
Antiviral drugs
Blood diseases
Case reports
Central nervous system vasculitis
Clinical Case Study
Cryoglobulinemia
Direct antiviral agents
Hepatitis
Hepatitis C
Hepatitis C virus infection
Immunology
Infections
Liver
Nervous system
Neurological disorders
Neurosarcoidosis
NMR
Nuclear magnetic resonance
Patients
Sarcoidosis
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Summary:Background: Neurosarcoidosis is a rare manifestation of hepatitis C virus (HCV) infection, mainly in patients exposed to interferon-based therapies. Although we are living in a new era of HCV treatment, there is still little data concerning the treatment of extrahepatic complications of the disease with direct antiviral agents, especially rare ones such as neurosarcoidosis. Summary: We present a rare case of central nervous system vasculitic lesions in the context of chronic HCV infection associated with mixed cryoglobulinemia, elevated angiotensin-converting enzyme (ACE) levels, and documentation of viral RNA in the cerebrospinal fluid in a treatment-naïve chronic HCV patient. Successful treatment with an interferon-free regimen improved all clinical manifestations, reduced the levels of serum ACE, and reduced the cryoglobulin levels to undetectable. Messages: Neurosarcoidosis and cryoglobulinemia are rare but well-recognized complications of HCV infection, even in treatment-naïve patients. Direct antiviral agents can be useful in the management of this condition.
ISSN:2341-4545
2387-1954
DOI:10.1159/000492066