慢性丙型肝炎患者接受聚乙二醇干扰素和利巴韦林治疗后发生乳糜泻。
Celiac disease onset after pegylated interferon and ribavirin treatment of chronic hepatitis C.
作者信息
Martins Elson V, Gaburri Ana K
机构信息
Division of Internal Medicine, Gastroenterology and Hepatology Section, Faculdade de Ciências Médicas, Universidade Metropolitana de Santos, Santos, SP, Brazil.
出版信息
Arq Gastroenterol. 2004 Apr-Jun;41(2):132-3. doi: 10.1590/s0004-28032004000200012. Epub 2004 Oct 27.
AIM
Report of a case of a woman patient who developed celiac disease after pegylated interferon alpha-2a and ribavirin use for chronic hepatitis C.
PATIENT AND METHOD
A 34-year-old woman with chronic hepatitis C, genotype 3, receiving pegylated interferon alpha-2a and ribavirin for 6 months, developed progressive malaise and anemia 6 months after the end of treatment.
RESULT
Additional investigation revealed duodenal villous atrophy and positivity for anti-endomysium and anti-gliadin antibodies. Celiac disease diagnosis was performed and symptoms and laboratory abnormalities improved after gluten-free diet.
CONCLUSION
Celiac disease must be ruled out in patients with malabsorption complaints in or after interferon (or pegylated interferon) therapy. Screening for celiac disease with detection of anti-endomysium antibodies would be done in susceptible patients.
目的
报告一例女性患者在使用聚乙二醇化干扰素α-2a和利巴韦林治疗慢性丙型肝炎后发生乳糜泻的病例。
患者与方法
一名34岁、基因型为3型的慢性丙型肝炎女性患者，接受聚乙二醇化干扰素α-2a和利巴韦林治疗6个月，在治疗结束6个月后出现进行性不适和贫血。
结果
进一步检查发现十二指肠绒毛萎缩，抗肌内膜抗体和抗麦醇溶蛋白抗体呈阳性。确诊为乳糜泻，采用无麸质饮食后症状和实验室异常情况得到改善。
结论
对于在干扰素（或聚乙二醇化干扰素）治疗期间或之后出现吸收不良症状的患者，必须排除乳糜泻。对于易感患者，应通过检测抗肌内膜抗体来筛查乳糜泻。
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