Takata Kazuhide, Shakado Satoshi, Sakamoto Keiko, Fukuda Hiromi, Yamauchi Ryo, Fukuda Sho, Kunimoto Hideo, Umeda Kaoru, Tanaka Takashi, Yokoyama Keiji, Morihara Daisuke, Takeyama Yasuaki, Irie Makoto, Sakisaka Shotaro
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan, Fukuoka, 814-0180, Japan.
Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Clin J Gastroenterol. 2017 Oct;10(5):459-463. doi: 10.1007/s12328-017-0772-x. Epub 2017 Sep 7.
Ultrasonography in a 60-year-old man with chronic hepatitis C (CHC) demonstrated multiple hyperechoic nodules. Radiological investigations did not reveal any signs of malignancy. However, magnetic resonance chemical shift imaging showed multiple focal fatty changes in the liver. Urinary levels of uroporphyrin and coproporphyrin were elevated, and we made a diagnosis of porphyria cutanea tarda. Direct-acting antivirals, ledipasvir/sofosbuvir, were initiated for CHC, which led to sustained viral response, resolution of the liver nodules, and normalization of urinary porphyrin. Hepatitis C virus infection can cause porphyria cutanea tarda with multiple hyperechoic liver nodules, which might be cured by direct-acting antivirals.
一名60岁慢性丙型肝炎（CHC）男性患者的超声检查显示有多个高回声结节。影像学检查未发现任何恶性迹象。然而，磁共振化学位移成像显示肝脏有多处局灶性脂肪变性。尿中尿卟啉和粪卟啉水平升高，我们诊断为迟发性皮肤卟啉症。开始使用直接抗病毒药物来迪派韦/索磷布韦治疗CHC，这导致了病毒持续应答、肝结节消退以及尿卟啉正常化。丙型肝炎病毒感染可导致伴有多个高回声肝结节的迟发性皮肤卟啉症，而直接抗病毒药物可能治愈该病。
