LETTER
Extrahepatic Manifestations of Hepatitis C Virus Infection
Jean Marc Durand, MD;
Gilles Kaplanski, MD; and
Jacques Soubeyrand, MD
15 August 1996 | Volume 125 Issue 4 | Page 345
TO THE EDITOR:
We read with interest the report by Gumber and Chopra [1] on extrahepatic manifestations of HCV infection. We agree that the prevalence of extrahepatic abnormalities, including cryoglobulinemia, membranoproliferative glomerulonephritis, porphyria cutanea tarda, and autoimmune thyroiditis, is high in patients with chronic hepatitis C. We also believe that patients with autoimmune thrombocytopenia should be tested for HCV infection. Indeed, thrombocytopenia associated with serologic results positive for HCV has recently been recognized [2, 3]. Immune thrombocytopenia after interferon-
therapy has been noted [4], but this effect is uncommon. We believe that interferon therapy for chronic hepatitis C need not be systematically avoided just because of thrombocytopenia. Moreover, we reported that interferon treatment may be useful in thrombocytopenia associated with HCV infection [5].
According to available data, the association between HCV and autoimmune thrombocytopenia requires further confirmation. However, we suggest that this association should be considered, given its possible implications for therapeutic options in patients with chronic HCV infection.
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Author and Article Information
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CHU de Sainte-Marguerite, 13274 Marseille, France
1. Gumber SC, Chopra SA. Hepatitis C: a multifaceted disease. Review of extrahepatic manifestations. Ann Intern Med. 1995; 123:615-20.
2. Durand JM, Lefevre P, Telle H, Kaplanski G, Quiles N, Soubeyrand J. Thrombocytopenic purpura and hepatitis C virus infection. Haematologica. 1993; 78:135.
3. Dine G, Brahimi S. Thrombopenie de I'adulte associee a une serologie VHC positive. Presse Med. 1993; 22:269.
4. Lopez-Morante AJ, Saez-Royuela F, Casanova Valero F, Yuguero del Moral L, Martin Lorente JL, Ojeda Gimenez C. Immune thrombocytopenia after interferon therapy. Am J Gastroenterol. 1992; 87:809-10.
5. Durand JM, Cretel E, Retornaz F, Lefevre P, Kaplanski G, Soubeyrand J. Alpha interferon therapy in thrombocytopenia associated with hepatitis C virus (HCV) infection. J Hepatol. 1994; 21:277.
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