Treatment with pegylated interferon and ribavirin for hepatitis C virus-associated severe cryoglobulinemia in a liver/kidney transplant recipient

Marzia Montalbano, Luisa Pasulo, Aurelio Sonzogni, Giuseppe Remuzzi, Michele Colledan, Mario Strazzabosco

Research output: Contribution to journalArticlepeer-review

Abstract

End-stage liver disease after hepatitis C virus (HCV) infection is the most common indication for liver transplantation, accounting for over 40% of liver transplants performed. Combined liver/kidney transplantation is being performed more frequently, in part because HCV infection may coexist with conditions that damage the kidney, such as diabetes and cryoglobulinemia. Unfortunately, HCV hepatitis and cryoglobulinemia may recur after liver transplantation and adversely affect graft and patient survival. In immunocompetent patients, interferon (IFN) and ribavirin (RBV) combination therapy is often able to control cryoglobulinemic syndrome. Very little data are available on liver transplant recipients, whereas IFN usually is not indicated in kidney transplant recipients because of early reports of steroid-induced rejection after its administration. Successful treatment of cryoglobulinemia with IFN/RBV in recipients of combined liver/kidney transplant has not been previously reported. We treated 1 recipient of a combined liver and kidney transplant with pegylated-IFN/RBV combination therapy. The patient developed HCV recurrence associated with cryoglobulinemia and severe cutaneous peripheral and neurologic manifestations. Treatment with pegylated-IFN-α2b and RBV for 12 months cured the cryoglobulinemic vasculitis and allowed the sustained eradication of HCV with no significant changes in kidney function.

Original languageEnglish
Pages (from-to)216-220
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume41
Issue number2
DOIs
Publication statusPublished - Feb 2007

Keywords

  • Cryoglobulin
  • Hepatitis C virus
  • Kidney transplantation
  • Liver tranplantation
  • Pegylated interferon

ASJC Scopus subject areas

  • Gastroenterology

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