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一例慢性丙型肝炎合并糖尿病肾病性肾病患者,通过双重滤过血浆置换和干扰素联合治疗实现了持续病毒缓解。

A case of chronic hepatitis C with nephrotic diabetic nephropathy who achieved sustained viral remission by double-filtration plasmapheresis and interferon combination therapy.

作者信息

Okuyama Hiroshi, Kimura Syogo, Fujimoto Keiji, Imura Junko, Chikazawa Yoshihiro, Nakagawa Masaru, Yamaya Hideki, Yokoyama Hitoshi

机构信息

Division of Nephrology, Kanazawa Medical University School of Medicine, Japan.

出版信息

Intern Med. 2012;51(15):1991-5. doi: 10.2169/internalmedicine.51.7117. Epub 2012 Aug 1.

Abstract

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).

摘要

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。

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