Mycophenolate mofetil in the treatment of autoimmune HCV-associated haematological disorders showing steroid resistance or dependence

Enzo Ierardi, M. Rendina, R. Francavilla, M. Barone, A. Castellaneta, C. Panella, A. Francavilla, R. Cuomo

Research output: Contribution to journalArticlepeer-review

Abstract

We report two cases of hepatitis C virus (HCV) associated autoimmune haematological disorders successfully treated with an unusual protocol (mycophenolate mofetil: MMF). The first case was a male patient with chronic HCV infection who developed, during interferon (IFN)/ribavirin therapy, severe autoimmune thrombocytopenia unresponsive to steroids. MMF was then administered and, simultaneously, the steroid dose was gradually reduced until withdrawal. Following this strategy, a progressive increase in platelet count and complete negativity of anti-PLT antibodies were achieved without changes in HCV-RNA quantitative determination. The second case was a woman with HCV liver cirrhosis with severe anaemia and Coombs test positivity partially responsive to continuous administration of steroid high doses. However, this treatment unmasked a severely painful vertebral osteoporosis. For this reason we introduced MMF and simultaneously steroid therapy was progressively reduced until withdrawal. Haemoglobin reached a normal value and the Coombs test became negative within 60 days. These case reports suggest that MMF may represent an interesting therapeutic approach for autoimmune HCV associated haematological disorders.

Original languageEnglish
Pages (from-to)390-393
Number of pages4
JournalJournal of Viral Hepatitis
Volume10
Issue number5
DOIs
Publication statusPublished - Sep 2003

Keywords

  • Autoimmune disorders
  • Haemolytic anemia
  • Hepatitis C virus
  • Immunosuppressive drugs
  • Mycophenolate mofetil
  • Thrombocytopenia

ASJC Scopus subject areas

  • Hepatology
  • Virology

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