Hepatitis C virus infection: 'beyond the liver'

BMJ Case Rep. 2018 Jul 25:2018:bcr2018225817. doi: 10.1136/bcr-2018-225817.

Abstract

There are rare reports of association between hepatitis C virus (HCV) infection and dermatomyositis although cause and effect remains to be proven. We present a clinical case with a probable cause and effect association between these two entities. A 71-year-old woman developed an erythematous exanthem with pruritic and scaly lesions located at the torso and upper limbs associated with heliotrope and Gottron's papules. At the same time, she notice a significant loss of muscular strength. Skin and muscular biopsies made the diagnosis of dermatomyositis and the patient started with prednisolone (60 mg/day) with poor symptoms control. Paraneoplastic syndrome, HIV, hepatitis B virus and syphilis infections were excluded. HCV serology was positive, with a viral load of 58 159 IU/mL (genotype 1a). Therefore, the patient underwent a 12-week treatment with grazoprevir 100 mg and elbasvir 50 mg achieving a sustained virological response with regression of skin lesions and complete recovery of muscular strength (photodocumented before/after treatment). Additionally it was possible to reduce prednisolone dosage to 5 mg/day.

Keywords: dermatology; hepatitis C.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amides
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use
  • Benzofurans / administration & dosage
  • Benzofurans / therapeutic use
  • Carbamates
  • Cyclopropanes
  • Dermatomyositis / complications
  • Dermatomyositis / diagnosis*
  • Dermatomyositis / drug therapy
  • Dermatomyositis / pathology
  • Diagnosis, Differential
  • Female
  • Hepatitis C / complications
  • Hepatitis C / diagnosis*
  • Hepatitis C / drug therapy
  • Hepatitis C / virology
  • Humans
  • Imidazoles / administration & dosage
  • Imidazoles / therapeutic use
  • Quinoxalines / administration & dosage
  • Quinoxalines / therapeutic use
  • Sulfonamides
  • Viral Load

Substances

  • Amides
  • Antiviral Agents
  • Benzofurans
  • Carbamates
  • Cyclopropanes
  • Imidazoles
  • Quinoxalines
  • Sulfonamides
  • grazoprevir
  • elbasvir