Department of Hematology, Asahi General Hospital, Japan.
Department of Gastroenterology, Asahi General Hospital, Japan.
Intern Med. 2021 Aug 1;60(15):2469-2473. doi: 10.2169/internalmedicine.6758-20. Epub 2021 Feb 15.
We herein report the case of a 54-year-old Japanese man with hepatitis C virus (HCV)-related membranoproliferative glomerulonephritis (MPGN), which developed at the time of relapse of immune thrombocytopenic purpura (ITP) after rituximab therapy. Antiviral therapy for HCV led to the improvement of both MPGN and ITP. Rituximab therapy may have contributed to the exacerbation of HCV infection and induced the development of HCV-related MPGN and the relapse of ITP. Our case suggested that HCV treatment should be prioritized over rituximab therapy for HCV-positive patients with ITP and that antiviral therapy for HCV may be effective for treating ITP itself.
我们在此报告一例 54 岁日本男性，患有丙型肝炎病毒（HCV）相关的膜增生性肾小球肾炎（MPGN），在利妥昔单抗治疗后免疫性血小板减少性紫癜（ITP）复发时发生。针对 HCV 的抗病毒治疗导致 MPGN 和 ITP 均得到改善。利妥昔单抗治疗可能导致 HCV 感染恶化，并诱导 HCV 相关 MPGN 的发生和 ITP 的复发。我们的病例提示，对于 HCV 阳性的 ITP 患者，应优先进行 HCV 治疗，而非利妥昔单抗治疗，并且针对 HCV 的抗病毒治疗可能对治疗 ITP 本身有效。
