丙型肝炎病毒相关性冷球蛋白血症性网状青斑经直接作用抗病毒药物治疗后改善。
Hepatitis C Virus-associated Cryoglobulinemic Livedo Reticularis Improved with Direct-acting Antivirals.
机构信息
Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan.
Department of Dermatology, Fukuoka University Faculty of Medicine, Japan.
出版信息
Intern Med. 2023 Dec 15;62(24):3631-3636. doi: 10.2169/internalmedicine.1671-23. Epub 2023 Apr 28.
We herein report a case of hepatitis C virus (HCV)-associated cryoglobulinemic livedo reticularis in a woman in her 60s that improved with direct-acting antivirals (DAAs). Hyperpigmentation was observed in both lower legs, and a skin biopsy confirmed livedo reticularis, suggesting a relationship with cryoglobulinemia and HCV infection. DAAs with an NS5A inhibitor+NS3/4A protease inhibitor (glecaprevir/pibrentasvir) were administered for eight weeks, and a sustained virological response (SVR) was obtained. The disappearance of serum cryoglobulin was confirmed approximately two years after an SVR was obtained and livedo reticularis was improved. DAA therapy can be an effective therapeutic option for extrahepatic complications associated with HCV infection.
我们在此报告一例 60 多岁女性的丙型肝炎病毒（HCV）相关冷球蛋白血症性网状青斑，其在直接作用抗病毒药物（DAAs）治疗后得到改善。双小腿均可见色素沉着，皮肤活检证实为网状青斑，提示与冷球蛋白血症和 HCV 感染有关。给予含 NS5A 抑制剂+NS3/4A 蛋白酶抑制剂（格卡瑞韦/哌仑他韦）的 DAA 治疗 8 周，获得持续病毒学应答（SVR）。获得 SVR 约两年后，血清冷球蛋白消失，网状青斑得到改善。DAA 治疗可能是 HCV 感染相关肝外并发症的有效治疗选择。
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