Okuyama Hiroshi, Kimura Syogo, Fujimoto Keiji, Imura Junko, Chikazawa Yoshihiro, Nakagawa Masaru, Yamaya Hideki, Yokoyama Hitoshi
Division of Nephrology, Kanazawa Medical University School of Medicine, Japan.
Intern Med. 2012;51(15):1991-5. doi: 10.2169/internalmedicine.51.7117. Epub 2012 Aug 1.
We report a 66-year-old man with chronic hepatitis caused by hepatitis type C virus of genotype-1b and high-viral-load combined with cryoglobulinemia and advanced diabetic nephropathy in whom we successfully achieved viral removal and eradication by DFPP (VRAD). The dose of PEG-interferon was reduced to 70 mg/week due to thrombocytopenia. Rivavirin was discontinued at day 21 due to anemia. Even with treatment of PEG-interferon alone, the condition was judged to be sustained viral remission at the end of the observation. This is a successful report of VRAD in a combined case of diabetic and HCV-related cryoglobulin-nephropathy with nephrotic syndrome. The therapeutic effect of IFN seemed to be efficiently enhanced by concomitant DFPP (VRAD therapy).
我们报告了一名66岁男性,患有由1b型丙型肝炎病毒引起的慢性肝炎且病毒载量高,同时合并冷球蛋白血症和晚期糖尿病肾病,我们通过双重滤过血浆置换(VRAD)成功实现了病毒清除和根除。由于血小板减少,聚乙二醇干扰素的剂量减至70mg/周。由于贫血,利巴韦林在第21天停药。即使仅用聚乙二醇干扰素治疗,在观察结束时病情仍被判定为持续病毒缓解。这是在糖尿病合并HCV相关冷球蛋白性肾病伴肾病综合征的联合病例中VRAD治疗成功的报告。干扰素的治疗效果似乎通过联合DFPP(VRAD疗法)得到了有效增强。