Mycophenolate mofetil in the treatment of autoimmune HCV-associated haematological disorders showing steroid resistance or dependence.

Abstract

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.

• Authors: E Ierardi, M Rendina, R Francavilla, M Barone, A Castellaneta, C Panella, A Francavilla, R Cuomo
• Journal: Journal of viral hepatitis (J Viral Hepat) Vol. 10 Issue 5 Pg. 390-3 (Sep 2003) ISSN: 1352-0504 [Print] England
• PMID: 12969191 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antiviral Agents
• Glucocorticoids
• Immunosuppressive Agents
• Interferons
• Mycophenolic Acid
• Methylprednisolone

Topics

• Aged
• Anemia, Hemolytic (drug therapy, etiology)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antiviral Agents (adverse effects, therapeutic use)
• Autoimmune Diseases (drug therapy, etiology)
• Drug Resistance
• Female
• Glucocorticoids (therapeutic use)
• Hepatitis C, Chronic (complications, drug therapy)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Interferons (adverse effects, therapeutic use)
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Thrombocytopenia (chemically induced, drug therapy)
• Withholding Treatment