[Severe thrombocytopenia during interferon-alpha therapy for chronic active hepatitis C associated with systemic...

We herein report a case of chronic active hepatitis C which developed a severe thrombocytopenia during an interferon therapy. The case is a 34 year-old-female, who admitted for the inactive stage systemic lupus erythematosus based on the laboratory findings and the episodes of polyarthralgia. HCV-RNA was positive and the Ristology of the liver biopsy specimen showed the feature of chronic active hepatitis. Under the diagnosis of C type chronic active hepatitis, the natural interferon-alfa therapy was started. After administering the total dose of 366M units of the interferon, purpura developed and the total blood counts revealed pancytopenia, especially severe thrombocytopenia. However, by administering packed red blood cells, platelets and prednisolone, the pancytopenia promptly recovered. Involvement of an immunological mechanism is considered as a cause of the pancytopenia. However, anti-platelet antibody and platelet-associated antibody were both negative and the bone marrow tap revealed a hypoplastic marrow. Therefore, cytotoxic cytokines induced by the interferon was considered to be a factor which caused the pancytopenia in this patient.