Correspondence
Possible Association between Behçet's Syndrome and Chronic Hepatitis C Virus Infection
N Engl J Med 1995; 332:400-401February 9, 1995
- Article
To the Editor:
A number of immunologic disorders are known to be associated with chronic hepatitis C virus (HCV) infection.1 We report a possible association between chronic HCV infection and Behçet's syndrome.
A previously healthy woman was infected with HCV by the administration of coagulation factors in 1985. Acute hepatitis developed, followed by persistent moderate elevations of aminotransferase levels. In 1990 the patient presented with oral and genital ulcerations, pustules on the upper part of the body, polyarthritis, conjunctivitis, and fever. Behçet's syndrome was diagnosed, and therapy with prednisone reduced the symptoms. Azathioprine was then added to the treatment regimen.
In April 1993 the patient reported arthralgias and weakness of the larger muscles. The levels of aspartate aminotransferase (39 U per liter) and alanine aminotransferase (77 U per liter) were elevated, and HCV was detected in the serum by the polymerase chain reaction. A liver biopsy revealed moderately active hepatitis. Because the patient had persistent arthralgias and weakness, we initiated therapy with interferon alfa-2a (Roferon-A, Hoffmann–LaRoche) at a dose of 3 million units three times per week and gradually withdrew the immunosuppressants. Her aminotransferase levels have been in the normal range since July 1993.
Because of the persistence of HCV in the serum, treatment with interferon alfa-2a has been continued at a dose of 3 million units per day since March 1994. HCV RNA is no longer detectable in the serum or in liver tissue. There have been no symptoms of Behçet's syndrome since immunosuppressive therapy was discontinued. Our findings suggest that Behçet's syndrome may be another HCV-associated autoimmune disease2-4 that can be controlled by the administration of interferon alfa-2a.
4 ReferencesHans Münke, M.D.
Fritz Stöckmann, M.D.
Giuliano Ramadori, M.D.
Georg-August-Universität Göttingen, 37075 Göttingen, Germany1
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Gulen Hatemi, Hasan Yazici. (2011) Behçet’s syndrome and micro-organisms. Best Practice & Research Clinical Rheumatology 25:3, 389-406
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Daijiro Iga, Masahiko Tomimatsu, Hitoshi Endo, Shin-Ichiro Ohkawa, Osamu Yamada. (2005) Improvement of thrombocytopenia with disappearance of HCV RNA in patients treated by interferon-alpha therapy: possible etiology of HCV-associated immune thrombocytopenia. European Journal of Haematology 75:5, 417-423
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Full Text19
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