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Mycophenolate mofetil in the treatment of autoimmune HCV‐associated haematological disorders showing steroid resistance or dependence
Author(s) -
Ierardi E.,
Rendina M.,
Francavilla R.,
Barone M.,
Castellaneta A.,
Panella C.,
Francavilla A.,
Cuomo R.
Publication year - 2003
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1046/j.1365-2893.2003.00438.x
Subject(s) - medicine , mycophenolate , ribavirin , autoimmune hepatitis , immunology , hepatitis c virus , cirrhosis , gastroenterology , hepatitis , virus , transplantation
Summary. We report two cases of hepatitis C virus (HCV) associated autoimmune haematological disorders successfully treated with an unusual protocol (mycophenolate mofetil: MMF). The first case was a male patient with chronic HCV infection who developed, during interferon (IFN)/ribavirin therapy, severe autoimmune thrombocytopenia unresponsive to steroids. MMF was then administered and, simultaneously, the steroid dose was gradually reduced until withdrawal. Following this strategy, a progressive increase in platelet count and complete negativity of anti‐PLT antibodies were achieved without changes in HCV‐RNA quantitative determination. The second case was a woman with HCV liver cirrhosis with severe anaemia and Coombs test positivity partially responsive to continuous administration of steroid high doses. However, this treatment unmasked a severely painful vertebral osteoporosis. For this reason we introduced MMF and simultaneously steroid therapy was progressively reduced until withdrawal. Haemoglobin reached a normal value and the Coombs test became negative within 60 days. These case reports suggest that MMF may represent an interesting therapeutic approach for autoimmune HCV associated haematological disorders.