Sunday, 7 December 2014
Exhibition Hall-Poster Area (Sul America)
Fabiana Mascarenhas, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Leonardo Mendonça, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Pablo Torres, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Karla Boufleur, MD
,
Clinical Immunology and Allergy, Hcfmusp, Brazil
Eduardo Longen, MD
,
Clinical Immunology and Allergy Division, University of São Paulo, São Paulo, Brazil
Jorge Kalil, PhD
,
Department of Allergy and Immunology, University of São Paulo, São Paulo, Brazil
Myrthes Toledo Barros, PhD, MD
,
Clinical Immunology and Allergy, Hospital Das Clínicas - Faculdade De Medicina - USP, Brazil
Background: Hepatitis C virus (HCV) is an important public health problem worldwide. Immunological complications are found in 40-74% of patients with HCV, as well as the prevalence of HCV infection is higher among individuals with these conditions, suggesting a pathogenetic virus influence.
As a systemic pathology, autoimmunity may occur even without hepatic manifestations. Studies indicate that peripheral nervous system disorders have been observed as complications of HCV infection. This case report is about a 56 year old male patient with skin scaly erythematous lesions and stellate hypo pigmented spots, muscle atrophy of the extremities and peripheral neuropathy march with diffuse muscle weakness associated with a positive history of hepatitis.
Methods: Clinical, image and laboratoy records of Hospital das Clínicas da FMUSP review. Skin biopsy, neurologyc investigation and hepatits C treatment were performed. Understanding the association between HCV and autoimmune manifestations, may light to virus testing, beyond to indicate antiviral e immunomodulatory treatment.
Results: Biopsy of skin lesions showed inflammatory features, some with fibrinoid necrosis. Electromyography demonstrated myopathy and neuropathy pattern. Nerve biopsy revealed vasculitic neuropathy. The patient was submitted to hepatitis C treatment with purpose to control autoimmune manifestations, but had several collateral effects that required avoidance of the drug. It was also tried several immunosuppressive medications, but all tended to fail and partially control was acquired with cyclosporine.
Conclusions: Imunossupressive treatment and hepatitis C treatment should be used to control autoimmune manifestations related to virus C infection.
