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

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Resumo: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.
Autores principais:Lima,Sérgio
Outros Autores:Faria,Raquel; Nery,Filipe
Assunto:Hepatitis C virus infection Neurosarcoidosis Central nervous system vasculitis Direct antiviral agents Cryoglobulinemia
Ano:2019
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Lima,Sérgio
author2 Faria,Raquel
Nery,Filipe
author2_role author
author
author_facet Lima,Sérgio
Faria,Raquel
Nery,Filipe
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Lima,Sérgio\"},{\"Person.name\":\"Faria,Raquel\"},{\"Person.name\":\"Nery,Filipe\"}]
datacite.creators.creator.creatorName.fl_str_mv Lima,Sérgio
Faria,Raquel
Nery,Filipe
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
datacite.titles.title.fl_str_mv Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
dc.creator.none.fl_str_mv Lima,Sérgio
Faria,Raquel
Nery,Filipe
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000400008
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv GE-Portuguese Journal of Gastroenterology v.26 n.4 2019
dc.subject.none.fl_str_mv Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
dc.title.fl_str_mv Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_93fc
description 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.
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institution Fundação para a Ciência e Tecnologia
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person_str_mv Lima,Sérgio
Faria,Raquel
Nery,Filipe
publishDate 2019
publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
reponame_str SciELO Portugal
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spelling Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free RegimenLima,SérgioFaria,RaquelNery,FilipeHepatitis C virus infectionNeurosarcoidosisCentral nervous system vasculitisDirect antiviral agentsCryoglobulinemiaopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000400008URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000400008URLHasVersion2019-08-01Background: 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.Sociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.26 n.4 2019text/htmlengreporthttp://purl.org/coar/resource_type/c_93fcother research product
spellingShingle Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
Lima,Sérgio
Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
status SINGLETON
subject.fl_str_mv Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
title Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
title_full Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
title_fullStr Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
title_full_unstemmed Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
title_short Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
title_sort Improvement of Central Nervous System Vasculitis in a Patient with Chronic Hepatitis C Virus Infection after Treatment with an Interferon-Free Regimen
topic Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
topic_facet Hepatitis C virus infection
Neurosarcoidosis
Central nervous system vasculitis
Direct antiviral agents
Cryoglobulinemia
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000400008
visible 1