Ischaemic jejunal vasculitis during treatment with pegylated interferon-alpha 2b and ribavirin for hepatitis C virus related cirrhosis

A 53-year-old male with compensated cirrhosis (Child–Pugh class A5) and mixed cryoglobulinaemia (cryocrit: 2.0%), both hepatitis C virus-related, was treated with pegylated interferon-alpha 2b and ribavirin. After three months of therapy, he developed segmental jejunal vasculitis requiring emergency...

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Bibliographic Details
Published in:Digestive and liver disease 2006-05, Vol.38 (5), p.352-354
Main Authors: Pompili, M., Pizzolante, F., Larocca, L.M., Covino, M., Rapaccini, G.L., Gasbarrini, G.
Format: Article
Language:English
Subjects:
Antiviral Agents - adverse effects
Drug Therapy, Combination
Hepatitis C, Chronic - drug therapy
Humans
Infarction
Interferon
Interferon-alpha - adverse effects
Ischemia - chemically induced
Ischemia - pathology
Jejunum - blood supply
Jejunum - pathology
Liver cirrhosis
Liver Cirrhosis - drug therapy
Liver Cirrhosis - virology
Male
Middle Aged
Polyethylene Glycols
Recombinant Proteins
Ribavirin - adverse effects
Small bowel
Vasculitis
Vasculitis - chemically induced
Vasculitis - pathology
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Summary:A 53-year-old male with compensated cirrhosis (Child–Pugh class A5) and mixed cryoglobulinaemia (cryocrit: 2.0%), both hepatitis C virus-related, was treated with pegylated interferon-alpha 2b and ribavirin. After three months of therapy, he developed segmental jejunal vasculitis requiring emergency resection of an ischaemic intestinal loop 60 cm long. Pathological examination of the surgical specimen revealed signs of ischaemic injury with haemorrhagic infarction due to arteritis and arterial occlusion. The postoperative course was complicated by progressive liver and renal failure that led to the patient's death six months after surgery. To our knowledge, ischaemic jejunal vasculitis has never been reported during interferon therapy, but the latter treatment may have played causative roles.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2005.07.008