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Immune thrombocytopenic purpura in patients with hepatitis C virus infection
Hiroaki Nakajima1, Hitoshi Takagi, Yuichi Yamazaki
1Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Background/Aims:
Immune thrombocytopenic purpura could occur as an extrahepatic manifestation of hepatitis C virus infection. The aim of this study was to clinically analyze hepatitis C virus-positive cases with immune thrombocytopenic purpura and to examine the relationship between hepatitis C virus and immune thrombocytopenic purpura.
Methodology:
Eight hepatitis C virus-positive patients with immune thrombocytopenic purpura were compared with 67 cases with chronic hepatitis C without immune thrombocytopenic purpura. We examined various clinical and hematological parameters including platelet and platelet-associated immunoglobulin G.
Results:
Two men and 6 women with hepatitis C virus infection (age 58.0 +/- 11.8) were diagnosed with immune thrombocytopenic purpura. Platelet counts (x10(4)/mm3) were significantly lower in these 8 patients (2.9 +/- 2.1) than in chronic hepatitis C patients without immune thrombocytopenic purpura (16.7 +/- 0.3) (P<0.001). Hepatitis C virus infection predated immune thrombocytopenic purpura in 6 patients and none of the patients with immune thrombocytopenic purpura was infected with hepatitis C virus after the diagnosis. Three of the 6 patients with chronic hepatitis C, which predated immune thrombocytopenic purpura, were treated with interferon and 2 developed immune thrombocytopenic purpura after the treatment. None of them eradicated hepatitis C virus by interferon.
Conclusions:
The fact that hepatitis C virus infection predated immune thrombocytopenic purpura in 6 of 8 patients suggests that hepatitis C virus could potentially induce immune thrombocytopenic purpura and interferon itself might induce immune thrombocytopenic purpura.
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